Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy
Introduction: We evaluated the association of pre-treatment immunologic biomarkers on the outcomes of early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: In this retrospective study, all newly diagnosed early-stage N...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/1/19 |
| _version_ | 1797494854083674112 |
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| author | Marina Aduquaye Sheen Dube Bashir Bashir Amitava Chowdhury Naseer Ahmed Ahmet Leylek Julian Kim Pascal Lambert Oliver Bucher William Hunter Gokulan Sivananthan Rashmi Koul Shrinivas Rathod |
| author_facet | Marina Aduquaye Sheen Dube Bashir Bashir Amitava Chowdhury Naseer Ahmed Ahmet Leylek Julian Kim Pascal Lambert Oliver Bucher William Hunter Gokulan Sivananthan Rashmi Koul Shrinivas Rathod |
| author_sort | Marina Aduquaye |
| collection | DOAJ |
| description | Introduction: We evaluated the association of pre-treatment immunologic biomarkers on the outcomes of early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: In this retrospective study, all newly diagnosed early-stage NSCLC treated with SBRT between January 2010 and December 2017 were screened and included for further analysis. The pre-treatment neutrophil-lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were calculated. Overall survival (OS) and recurrence-free survival (RFS) were estimated by Kaplan–Meier. Multivariable models were constructed to determine the impact of different biomarkers and the Akaike information criterion (AIC), index of adequacy, and scaled Brier scores were calculated. Results: A total of 72 patients were identified and 61 were included in final analysis. The median neutrophil count at baseline was 5.4 × 10<sup>9</sup>/L (IQR: 4.17–7.05 × 10<sup>9</sup>/L). Median lymphocyte count was 1.63 × 10<sup>9</sup>/L (IQR: 1.29–2.10 × 10<sup>9</sup>/L), median monocyte count was 0.65 × 10<sup>9</sup>/L (IQR: 0.54–0.83 × 10<sup>9</sup>/L), median platelet count was 260.0 × 10<sup>9</sup>/L (IQR: 211.0–302.0 × 10<sup>9</sup>/L). The median NLR was 3.42 (IQR: 2.38–5.04), median MLR was 0.39 (IQR: 0.31–0.53), and median PLR was 156.4 (IQR: 117.2–197.5). On multivariable regression a higher NLR was associated with worse OS (<i>p</i> = 0.01; HR-1.26; 95% CI 1.04–1.53). The delta AIC between the two multivariable models was 3.4, suggesting a moderate impact of NLR on OS. On multivariable analysis, higher NLR was associated with poor RFS (<i>p</i> = 0.001; NLR^1 HR 0.36; 0.17–0.78; NLR^2 HR-1.16; 95% CI 1.06–1.26) with a nonlinear relationship. The delta AIC between the two multivariable models was 16.2, suggesting a strong impact of NLR on RFS. In our cohort, MLR and PLR were not associated with RFS or OS in multivariable models. Conclusions: Our study suggests NLR, as a biomarker of systemic inflammation, is an independent prognostic factor for OS and RFS. The nonlinear relationship with RFS may indicate a suitable immunological environment is needed for optimal SBRT action and tumoricidal mechanisms. These findings require further validation in independent cohorts. |
| first_indexed | 2024-03-10T01:40:17Z |
| format | Article |
| id | doaj.art-528e3a29217f4f09b82d93c099fc40e1 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T01:40:17Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-528e3a29217f4f09b82d93c099fc40e12023-11-23T13:25:55ZengMDPI AGCurrent Oncology1198-00521718-77292022-01-0129119320810.3390/curroncol29010019Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation TherapyMarina Aduquaye0Sheen Dube1Bashir Bashir2Amitava Chowdhury3Naseer Ahmed4Ahmet Leylek5Julian Kim6Pascal Lambert7Oliver Bucher8William Hunter9Gokulan Sivananthan10Rashmi Koul11Shrinivas Rathod12Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Epidemiology and Cancer Research, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Epidemiology and Cancer Research, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaDepartment of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, CanadaIntroduction: We evaluated the association of pre-treatment immunologic biomarkers on the outcomes of early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT). Materials and methods: In this retrospective study, all newly diagnosed early-stage NSCLC treated with SBRT between January 2010 and December 2017 were screened and included for further analysis. The pre-treatment neutrophil-lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were calculated. Overall survival (OS) and recurrence-free survival (RFS) were estimated by Kaplan–Meier. Multivariable models were constructed to determine the impact of different biomarkers and the Akaike information criterion (AIC), index of adequacy, and scaled Brier scores were calculated. Results: A total of 72 patients were identified and 61 were included in final analysis. The median neutrophil count at baseline was 5.4 × 10<sup>9</sup>/L (IQR: 4.17–7.05 × 10<sup>9</sup>/L). Median lymphocyte count was 1.63 × 10<sup>9</sup>/L (IQR: 1.29–2.10 × 10<sup>9</sup>/L), median monocyte count was 0.65 × 10<sup>9</sup>/L (IQR: 0.54–0.83 × 10<sup>9</sup>/L), median platelet count was 260.0 × 10<sup>9</sup>/L (IQR: 211.0–302.0 × 10<sup>9</sup>/L). The median NLR was 3.42 (IQR: 2.38–5.04), median MLR was 0.39 (IQR: 0.31–0.53), and median PLR was 156.4 (IQR: 117.2–197.5). On multivariable regression a higher NLR was associated with worse OS (<i>p</i> = 0.01; HR-1.26; 95% CI 1.04–1.53). The delta AIC between the two multivariable models was 3.4, suggesting a moderate impact of NLR on OS. On multivariable analysis, higher NLR was associated with poor RFS (<i>p</i> = 0.001; NLR^1 HR 0.36; 0.17–0.78; NLR^2 HR-1.16; 95% CI 1.06–1.26) with a nonlinear relationship. The delta AIC between the two multivariable models was 16.2, suggesting a strong impact of NLR on RFS. In our cohort, MLR and PLR were not associated with RFS or OS in multivariable models. Conclusions: Our study suggests NLR, as a biomarker of systemic inflammation, is an independent prognostic factor for OS and RFS. The nonlinear relationship with RFS may indicate a suitable immunological environment is needed for optimal SBRT action and tumoricidal mechanisms. These findings require further validation in independent cohorts.https://www.mdpi.com/1718-7729/29/1/19biomarkersearly-stage lung cancerstereotactic body radiation therapy |
| spellingShingle | Marina Aduquaye Sheen Dube Bashir Bashir Amitava Chowdhury Naseer Ahmed Ahmet Leylek Julian Kim Pascal Lambert Oliver Bucher William Hunter Gokulan Sivananthan Rashmi Koul Shrinivas Rathod Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy Current Oncology biomarkers early-stage lung cancer stereotactic body radiation therapy |
| title | Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy |
| title_full | Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy |
| title_fullStr | Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy |
| title_full_unstemmed | Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy |
| title_short | Impact of Pre-Treatment NLR and Other Hematologic Biomarkers on the Outcomes of Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy |
| title_sort | impact of pre treatment nlr and other hematologic biomarkers on the outcomes of early stage non small cell lung cancer treated with stereotactic body radiation therapy |
| topic | biomarkers early-stage lung cancer stereotactic body radiation therapy |
| url | https://www.mdpi.com/1718-7729/29/1/19 |
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