The clinical relevance of laboratory prognostic scores for patients with radiosurgically treated brain metastases of non-pulmonary primary tumor

Abstract

Purpose To investigate the clinical value of the inflammation based prognostic scores for patients with radiosurgically treated brain metastases (BM) originating from non-pulmonary primary tumor (PT). Methods A retrospective analysis of 340 BM patients of different PT origin (melanoma, breast, gastrointestinal, or genitourinary cancer) was performed. Pre-radiosurgical laboratory prognostic scores, such as the Neutrophil-to-Lymphocyte Ratio (NLR), the Platelet-to-Lymphocyte Ratio (PLR), Lymphocyte-to-Monocyte Ratio (LMR), and the modified Glasgow Prognostic Score (mGPS), were investigated within 14 days before the first Gamma Knife radiosurgical treatment (GKRS1). Results In our study cohort, the estimated survival was significantly longer in patients with NLR < 5 (p < 0.001), LMR > 4 (p = 0.001) and in patients with a mGPS score of 0 (p < 0.001). Furthermore, univariate and multivariate Cox regression models revealed NLR ≥ 5, LMR < 4 and mGPS score ≥ 1 as independent prognostic factors for an increased risk of death even after adjusting for age, sex, KPS, extracranial metastases status, presence of neurological symptoms and treatment with immunotherapy (IT) or targeted therapy (TT). Conclusions Summarizing previously published and present data, pre-radiosurgical mGPS and NLR groups seem to be the most effective and simple independent prognostic factors to predict clinical outcome in radiosurgically treated BM patients.

Prognostic Evaluation of Metastasis-Related Lymphocyte/Monocyte Ratio in Stage Ⅰ-Ⅲ Breast Cancer Receiving Chemotherapy

“…It enabled us to compute a threshold based on diseases’ progress and be different from the results obtained by benign disease patients as the control cohort. The obtained cut-offs for CEA, CA153, CA125, killer T cell, and LMR are slightly higher for those found in previous studies (CEA: 5 ng/ml, CA153: 31.3 U/ml, B cell%: literature range: 7%–23%, Th/Tc: literature range: 0.9-3.6, LMR: literature range: 3-5.5) ( 20 , 30 – 32 , 37 – 39 ). ROC analysis showed that the accuracy of a single marker for diagnosis of stage I-III BC patients and stage IV BC patients was not high (AUC <0.800).…”

Comprehensive summary and retrospective evaluation of prognostic scores for patients with newly diagnosed brain metastases treated with upfront radiosurgery in a modern patient collective

“…Comprehensive summary and retrospective evaluation of prognostic scores for patients with newly diagnosed brain metastases treated with upfront radiosurgery in a modern patient collective. Radiotherapy and Oncology, 172,[23][24][25][26][27][28][29][30][31]…”

The indication of palliative whole-brain radiotherapy for patients with brain metastases: A simple prognostic scoring system in the era of stereotactic radiosurgery

“…Regarding the NLR ≥5, patients with a low NLR may experience prolonged survival after WBRT for advanced non-SCLC [22]. Similarly, the NLR has been reported to be a prognostic factor after resection [12] and radiation therapy [13] in patients with BM. To the best of our knowledge, this is the rst study to examine the NLR in patients with cancer who underwent pWBRT.…”

“…LabBM score consists of hemoglobin, platelet count, LDH, and C-reactive protein (CRP) in addition to albumin. Because systemic in ammation was reported to be associated with cancer development and progression [13], NLR, serum albumin, and CRP may be important factors in the cancer journey. Hence, blood tests can provide an objective measure of the current status of patients.…”

“…Blood tests can provide an objective measure of the current status of patients, which has recently been shown to correlate with outcomes in several cancers. For example, the neutrophil-lymphocyte ratio (NLR), which re ects systemic in ammation, is a predictor of overall survival (OS) after craniotomy [12] or STI [13] for BM, and serum albumin, which re ects nutritional status, is also a predictor of OS in patients with BM that is not from small cell lung cancer (SCLC) [14]. To predict the life expectancy of patients with BM, it may be helpful to combine the clinical characteristics and laboratory parameters of patients.…”