NLR & ALC as prognostic markers in patients treated with curative intent radiotherapy for NSCLC
Hiley, C. Punjabi, A. Barrett, E. Cheng, A. Mulla, A. Walls, G. Johnston, D. McAleese, J. Moore, K. Hicks, J.
Hiley, C.
Punjabi, A.
Barrett, E.
Cheng, A.
Mulla, A.
Walls, G.
Johnston, D.
McAleese, J.
Moore, K.
Hicks, J.
Citations
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Abstract
Purpose or Objective
Neutrophil-Lymphocyte ratio (NLR) and 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 pre and post curative-intent radiotherapy (RT) for NSCLC on disease recurrence and overall survival.
Materials and Methods
A retrospective study of consecutive patients who underwent curative-intent RT for NSCLC across 9 sites in the
UK from 01/10/2014 to 01/10/2016. A multivariate analysis was performed to assess the ability of pre-treatment NLR/ALC, post-treatment NLR/ALC and change in NLR/ALC, adjusted for co-founding factors using
the Cox proportional hazards model, to predict disease recurrence and overall survival (OS) within 2 years of
treatment. Results
425 patients were identified with complete blood parameter values. 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 (OR 1.71, 95%CI 1.06-2.79, p< 0.05), a post-NLR >5.5 (OR 2.36, 95%CI 1.49-3.76, p<
0.001], a change in NLR >3.6 (OR 2.41, 95%CI 1.5-3.91, p<0.001) and a post-ALC <0.8 (OR 2.86, 95%CI 1.76-
4.69, p <0.001) optimally predicted poor overall survival on both univariate and multivariate analysis when
adjusted for cofounding factors. None of the NLR/ALC parameters were independent predictors of disease
recurrence. 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.
Description
Date
2021
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Hiley C, Punjabi A, Barrett E, Cheng A, Mulla A, Walls G, et al. NLR & ALC as prognostic markers in patients treated with curative intent radiotherapy for NSCLC. Radiotherapy and Oncology. 2021;161:S183-S4.