Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation
Abstract Background A high neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and together with the platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in several solid tumors. We investigated the prognostic value of NLR and PLR in patients with head and neck...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-018-1159-y |
| _version_ | 1828759172605280256 |
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| author | Beat Bojaxhiu Arnoud J. Templeton Olgun Elicin Mohamed Shelan Kathrin Zaugg Marc Walser Roland Giger Daniel M. Aebersold Alan Dal Pra |
| author_facet | Beat Bojaxhiu Arnoud J. Templeton Olgun Elicin Mohamed Shelan Kathrin Zaugg Marc Walser Roland Giger Daniel M. Aebersold Alan Dal Pra |
| author_sort | Beat Bojaxhiu |
| collection | DOAJ |
| description | Abstract Background A high neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and together with the platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in several solid tumors. We investigated the prognostic value of NLR and PLR in patients with head and neck squamous cell carcinoma (HNSCC) treated with primary or adjuvant (chemo)radiotherapy ((C)RT). Methods A retrospective chart review of consecutive patients with HNSCC was performed. Neutrophil-to-lymphocyte ratio and PLR were computed using complete blood counts (CBCs) performed within 10 days before treatment start. The prognostic role of NLR and PLR was evaluated with univariable and multivariable Cox regression analyses adjusting for disease-specific prognostic factors. NLR and PLR were assessed as log-transformed continuous variables (log NLR and log PLR). Endpoints of interest were overall survival (OS), locoregional recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), and acute toxicity. Results We analyzed 186 patients treated from 2007 to 2010. Primary sites were oropharynx (45%), oral cavity (28%), hypopharynx (14%), and larynx (13%). Median follow-up was 49 months. Higher NLR was associated with OS (adjusted HR per 1 unit higher log NLR = 1.81 (1.16–2.81), p = 0.012), whereas no association could be shown with LRFS (HR = 1.49 (0,83-2,68), p = 0.182), DRFS (HR = 1.38 (0.65–3.22), p = 0.4), or acute toxicity grade ≥ 2. PLR was not associated with outcome, nor with toxicity. Conclusion Our data suggest that in HNSCC patients treated with primary or adjuvant (C)RT, NLR is an independent predictor of mortality, but not disease-specific outcomes or toxicity. Neutrophil-to-lymphocyte ratio is a readily available biomarker that could improve pre-treatment prognostication and may be used for risk-stratification. |
| first_indexed | 2024-12-11T00:53:26Z |
| format | Article |
| id | doaj.art-16740a267d11445a93880d7fc6b55c3f |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-11T00:53:26Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-16740a267d11445a93880d7fc6b55c3f2022-12-22T01:26:33ZengBMCRadiation Oncology1748-717X2018-11-011311910.1186/s13014-018-1159-yRelation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiationBeat Bojaxhiu0Arnoud J. Templeton1Olgun Elicin2Mohamed Shelan3Kathrin Zaugg4Marc Walser5Roland Giger6Daniel M. Aebersold7Alan Dal Pra8Department of Radiation Oncology, Inselspital, Bern University Hospital and University of BernDepartment of Medical Oncology, St. Claraspital Basel and Faculty of Medicine, University of BaselDepartment of Radiation Oncology, Inselspital, Bern University Hospital and University of BernDepartment of Radiation Oncology, Inselspital, Bern University Hospital and University of BernDepartment of Radiation Oncology, Stadtspital TriemliCenter for Proton Therapy, Paul Scherrer InstituteDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University HospitalDepartment of Radiation Oncology, Inselspital, Bern University Hospital and University of BernDepartment of Radiation Oncology, Inselspital, Bern University Hospital and University of BernAbstract Background A high neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and together with the platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in several solid tumors. We investigated the prognostic value of NLR and PLR in patients with head and neck squamous cell carcinoma (HNSCC) treated with primary or adjuvant (chemo)radiotherapy ((C)RT). Methods A retrospective chart review of consecutive patients with HNSCC was performed. Neutrophil-to-lymphocyte ratio and PLR were computed using complete blood counts (CBCs) performed within 10 days before treatment start. The prognostic role of NLR and PLR was evaluated with univariable and multivariable Cox regression analyses adjusting for disease-specific prognostic factors. NLR and PLR were assessed as log-transformed continuous variables (log NLR and log PLR). Endpoints of interest were overall survival (OS), locoregional recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), and acute toxicity. Results We analyzed 186 patients treated from 2007 to 2010. Primary sites were oropharynx (45%), oral cavity (28%), hypopharynx (14%), and larynx (13%). Median follow-up was 49 months. Higher NLR was associated with OS (adjusted HR per 1 unit higher log NLR = 1.81 (1.16–2.81), p = 0.012), whereas no association could be shown with LRFS (HR = 1.49 (0,83-2,68), p = 0.182), DRFS (HR = 1.38 (0.65–3.22), p = 0.4), or acute toxicity grade ≥ 2. PLR was not associated with outcome, nor with toxicity. Conclusion Our data suggest that in HNSCC patients treated with primary or adjuvant (C)RT, NLR is an independent predictor of mortality, but not disease-specific outcomes or toxicity. Neutrophil-to-lymphocyte ratio is a readily available biomarker that could improve pre-treatment prognostication and may be used for risk-stratification.http://link.springer.com/article/10.1186/s13014-018-1159-yHead and neckSquamous cell carcinomaInflammationNeutrophil-to-lymphocyte ratioPlatelet-to-lymphocyte ratioToxicity |
| spellingShingle | Beat Bojaxhiu Arnoud J. Templeton Olgun Elicin Mohamed Shelan Kathrin Zaugg Marc Walser Roland Giger Daniel M. Aebersold Alan Dal Pra Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation Radiation Oncology Head and neck Squamous cell carcinoma Inflammation Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Toxicity |
| title | Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation |
| title_full | Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation |
| title_fullStr | Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation |
| title_full_unstemmed | Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation |
| title_short | Relation of baseline neutrophil-to-lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with (chemo-) radiation |
| title_sort | relation of baseline neutrophil to lymphocyte ratio to survival and toxicity in head and neck cancer patients treated with chemo radiation |
| topic | Head and neck Squamous cell carcinoma Inflammation Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Toxicity |
| url | http://link.springer.com/article/10.1186/s13014-018-1159-y |
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