Neutrophil-Lymphocyte Ratio and Absolute Lymphocyte Count as Prognostic Markers in Patients Treated with Curative-intent Radiotherapy for Non-small Cell Lung Cancer

被引：16

作者：

Punjabi, A. ^{[1
]}

Barrett, E. ^{[1
]}

Cheng, A. ^{[1
]}

Mulla, A. ^{[1
]}

Walls, G. ^{[2
]}

Johnston, D. ^{[3
]}

McAleese, J. ^{[3
]}

Moore, K. ^{[4
]}

Hicks, J. ^{[4
]}

Blyth, K. ^{[4
]}

Denholm, M. ^{[5
]}

Magee, L. ^{[5
]}

Gilligan, D. ^{[5
]}

Silverman, S. ^{[6
]}

Qureshi, M. ^{[7
]}

Clinch, H. ^{[8
]}

Hatton, M. ^{[7
]}

Philipps, L. ^{[9
]}

Brown, S. ^{[10
]}

O'Brien, M. ^{[9
]}

McDonald, F. ^{[9
]}

Faivre-Finn, C. ^{[10
,11
]}

Hiley, C. ^{[12
]}

Evison, M. ^{[1
]}

机构：

[1] Manchester Univ NHS Fdn Trust, Wythenshawe Hosp, Manchester, Lancs, England

[2] Queens Univ Belfast, Belfast, Antrim, North Ireland

[3] Northern Ireland Canc Ctr, Belfast, Antrim, North Ireland

[4] NHS Greater Glasgow & Clyde, Glasgow, Lanark, Scotland

[5] Cambridge Univ Hosp NHS Trust, Cambridge, England

[6] Univ Coll London Hosp, London, England

[7] Weston Pk Hosp, Sheffield, S Yorkshire, England

[8] Univ Sheffield, Med Sch, Sheffield, S Yorkshire, England

[9] Royal Marsden Hosp, London, England

[10] Univ Manchester, Manchester, Lancs, England

[11] Christie NHS Fdn Trust, Manchester, Lancs, England

[12] UCL Canc Inst, CRUK Lung Canc Ctr Excellence, London, England

来源：

CLINICAL ONCOLOGY | 2021年 / 33卷 / 08期

关键词：

Curative-intent radiotherapy; lung cancer; lymphocyte count; neutrophil-lymphocyte ratio; NSCLC; LYMPHOPENIA; SURVIVAL;

D O I：

10.1016/j.clon.2021.03.019

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aims: The neutrophil-lymphocyte ratio (NLR) and the absolute lymphocyte count (ALC) have been proposed as prognostic markers in non-small cell lung cancer (NSCLC). The objective of this study was to examine the association of NLR/ALC before and after curative-intent radiotherapy for NSCLC on disease recurrence and overall survival. Materials and methods: A retrospective study of consecutive patients who underwent curative-intent radiotherapy for NSCLC across nine sites in the UK from 1 October 2014 to 1 October 2016. A multivariate analysis was carried out to assess the ability of pre-treatment NLR/ALC, post-treatment NLR/ALC and change in NLR/ALC, adjusted for confounding factors using the Cox proportional hazards model, to predict disease recurrence and overall survival within 2 years of treatment. Results: In total, 425 patients were identified with complete blood parameter values. None of the NLR/ALC parameters were independent predictors of disease recurrence. Higher pre-NLR, post-NLR and change in NLR plus lower post-ALC were all independent predictors of worse survival. Receiver operator curve analysis found a pre-NLR > 2.5 (odds ratio 1.71, 95% confidence interval 1.06-2.79, P < 0.05), a post-NLR > 5.5 (odds ratio 2.36, 95% confidence interval 1.49-3.76, P < 0.001), a change in NLR >3.6 (odds ratio 2.41, 95% confidence interval 1.5-3.91, P < 0.001) and a post-ALC < 0.8 (odds ratio 2.86, 95% confidence interval 1.76-4.69, P < 0.001) optimally predicted poor overall survival on both univariate and multivariate analysis when adjusted for confounding factors. Median overall survival for the high-versus low-risk groups were: pre-NLR 770 versus 1009 days (P 1/4 0.34), post-NLR 596 versus 1287 days (P <= 0.001), change in NLR 553 versus 1214 days (P <= 0.001) and post-ALC 594 versus 1287 days (P <= 0.001). Conclusion: NLR and ALC, surrogate markers for systemic inflammation, have prognostic value in NSCLC patients treated with curative-intent radiotherapy. These simple and readily available parameters may have a future role in risk stratification post-treatment to inform the intensity of surveillance protocols. (C) 2021 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

引用

页码：E331 / E338

页数：8

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