Longitudinal measurements of neutrophil-to-lymphocyte ratio in nasopharyngeal cancer treated with concurrent chemoradiotherapy

ObjectiveWe study factors affecting neutrophil-to-lymphocyte ratio (NLR) and its changes throughout the treatment (Delta NLR) of nasopharyngeal carcinoma (NPC) underwent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy (AC) and oncological outcomes including overall survival (OS) and disease-free survival (DFS).MethodsData from 81 NPC patients was retrospectively evaluated. NLRs were obtained from first week of CCRT (pre-CCRT), last week of CCRT (end-CCRT), and at last cycle of AC (end-AC). Pre-CCRT NLR was categorized into "low" and "high". End-CCRT and end-AC Delta NLRs were divided into "increased" and "decreased" based on NLR at these two timepoints relative to the value at pre-CCRT. Associations between sex, age, cancer stage and NLR, Delta NLRs were investigated. OS and DFS were reported.ResultsMedian NLR at pre-CCRT (2.47) was lower than NLR at end-CCRT (6.29) and end-AC (3.77) (P-value = 0.043). Advanced cancer stage associated with high pre-CCRT NLR (P-value = 0.047). Male gender was associated with "increased" end-CCRT Delta NLR, whereas male gender and age <= 51 were associated with "increased" end-AC Delta NLR. Three-year OS and DFS rates were 85.25% and 76.39%, respectively. There were no statistically significant differences observed in OS and DFS among groups categorized by pre-CCRT NLR, Delta NLRs, gender, age, and cancer stage.ConclusionsNLR increases during NPC treatment. Advanced staging is associated with higher baseline NLR. Increased Delta NLR is associated with male gender at end-CCRT and male gender with age <= 51 years at end-AC. No relation between NLR and its dynamic change with either OS or DFS was demonstrated.