Neutrophil lymphocyte ratio as a prognostic marker in patients treated with curative intent radiotherapy for non-small cell lung cancer
Punjabi, A. Barrett, E. Cheng, A. Mulla, A. Walls, G. Burke, D. McAleese, J. Moore, K. Hicks, J. Blyth, K.
Punjabi, A.
Barrett, E.
Cheng, A.
Mulla, A.
Walls, G.
Burke, D.
McAleese, J.
Moore, K.
Hicks, J.
Blyth, K.
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Abstract
Introduction: Neutrophil lymphocyte ratio (NLR), a marker
of systemic inflammation, has been found to have prognostic
significance in patients with non-small cell lung cancer (NSCLC) in
various studies. In this retrospective study we look at the impact
of NLR and the change in NLR in patients treated with different
modalities of curative intent radiotherapy (RT) for NSCLC.
Methods: We retrospectively analysed data from consecutive
patients who underwent curative intent RT for NSCLC across 9 sites
in UK from 01/10/2014 to 01/10/2016.Outcomes recorded included
disease recurrence and death (cancer vs non-cancer related).425
patients had their pre ( within 6 weeks) and post treatment values
(up to 4 weeks) recorded who were included in the final analysis.
Potential prognostic factors such as age, performance status and
disease stage were analysed. The survival rates were estimated with
Kaplan-Meier analysis. Univariate and multivariate analysis using
the Cox proportional hazards model were performed.
Results: 425 patients were followed up for 2 years. Recurrence and
death during the follow up were seen in 52% and 61% respectively.
Higher NLR pre and post were both associated with poorer overall survival (OS; p<0.05). Receiver operator curve analysis found pre
NLR >2.18 (OR 1.9, CI 1.21–3.03; p<0.001) and post NLR >5.26 (OR
2.65, CI 1.75–4.06; p<0.001) and difference in NLR( pre and post
treatment ) >6.2 (OR 1.97, CI 1.43–2.7; p<0.001) optimally predicted
poor overall survival on both univariate and multivariate analysis.
Pre and post NLR were not significantly associated with recurrence
outcomes. However, difference in NLR >–4.5 (OR 0.24, CI 0.12–0.48;
p=0001) predicted lower risk of recurrence.
Conclusion: This study shows that NLR, a surrogate marker for
systemic inflammation, has prognostic value in NSCLC patients
treated with curative intent radiotherapy. Further studies are
needed to evaluate its utility in predictive models for response to
radiotherapy to correlate with potential influencing factors such as
irradiated volume parameters and choice of systemic therapy.
Affiliation
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Punjabi A, Barrett E, Cheng A, Mulla A, Walls G, Burke D, et al. Neutrophil lymphocyte ratio as a prognostic marker in patients treated with curative intent radiotherapy for non-small cell lung cancer. Lung Cancer. 2020;139:S41-S2