Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy

Zhan Shi,1,* Sihui Zhu,2,* Yuncheng Jin,1 Liang Qi,1 Mingzhen Zhou,1 Ziyan Zhou,1 Juan Zhang,1 Baorui Liu,1 Jie Shen1 1Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University,...

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Main Authors: Shi Z, Zhu S, Jin Y, Qi L, Zhou M, Zhou Z, Zhang J, Liu B, Shen J
Format: Article
Language:English
Published: Dove Medical Press 2024-02-01
Series:Journal of Hepatocellular Carcinoma
Subjects:
Online Access:https://www.dovepress.com/lymphocyte-to-c-reactive-protein-ratio-is-an-independent-predictor-of--peer-reviewed-fulltext-article-JHC
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author Shi Z
Zhu S
Jin Y
Qi L
Zhou M
Zhou Z
Zhang J
Liu B
Shen J
author_facet Shi Z
Zhu S
Jin Y
Qi L
Zhou M
Zhou Z
Zhang J
Liu B
Shen J
author_sort Shi Z
collection DOAJ
description Zhan Shi,1,* Sihui Zhu,2,* Yuncheng Jin,1 Liang Qi,1 Mingzhen Zhou,1 Ziyan Zhou,1 Juan Zhang,1 Baorui Liu,1 Jie Shen1 1Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China; 2The Comprehensive Cancer Centre of Nanjing International Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie Shen; Baorui Liu, Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China, Fax +86-025-83106666, Email shenjie2008nju@163.com; baoruiliu@nju.edu.cnBackground: Stereotactic body radiotherapy (SBRT) has emerged as an alternative approach for patients with hepatocellular carcinoma (HCC), and we aim to find potential prognostic biomarkers for HCC patients who received SBRT.Methods: In this study, we retrospectively analyzed HCC patients who underwent SBRT in our institution from January 2018 to December 2022. The inflammatory parameters, along with baseline patients’ characteristics were collected to elucidate the potential relationship with survival benefits and liver toxicities.Results: Overall, 35 patients were enrolled in our study. For the efficacy population (25 patients who underwent SBRT for primary liver lesions), the objective response rate (ORR) and disease control rate (DCR) were 60% and 100%, respectively. The median progression-free survival (PFS) was 9.9 months [95% confidence interval (CI) 5.6– 14.1 months], and the median overall survival (OS) was 18.5 months (95% CI 14.2– 22.8 months). We further confirmed that higher baseline lymphocyte-C-reactive protein ratio (LCR) (≥ 2361.11) was positively related to both longer PFS (12.0 vs 4.3 months, P = 0.002) and OS (21.9 vs 11.4 months, P = 0.022). Moreover, patients with diabetes and higher alpha-fetoprotein (AFP) (≥ 400 ng/mL) were also found to be associated with worse OS. The most common hepatotoxicity was elevated gamma-glutamyl transferase (GGT) (84.0%).Conclusion: In conclusion, for patients with inoperable HCC, SBRT resulted in satisfactory local control, survival benefits, and acceptable liver toxicity. Pre-radiotherapy LCR might be an independent and readily available predictor for survival, which facilitates us to find the most appropriate treatment options.Keywords: hepatocellular carcinoma, stereotactic body radiotherapy, lymphocyte-C-reactive  protein  ratio, survival, liver toxicity
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spelling doaj.art-6d6a73ee960143dbb5168e35ba4233432024-02-08T18:28:26ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692024-02-01Volume 1130531690325Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving RadiotherapyShi ZZhu SJin YQi LZhou MZhou ZZhang JLiu BShen JZhan Shi,1,* Sihui Zhu,2,* Yuncheng Jin,1 Liang Qi,1 Mingzhen Zhou,1 Ziyan Zhou,1 Juan Zhang,1 Baorui Liu,1 Jie Shen1 1Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China; 2The Comprehensive Cancer Centre of Nanjing International Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie Shen; Baorui Liu, Department of Oncology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, 210008, People’s Republic of China, Fax +86-025-83106666, Email shenjie2008nju@163.com; baoruiliu@nju.edu.cnBackground: Stereotactic body radiotherapy (SBRT) has emerged as an alternative approach for patients with hepatocellular carcinoma (HCC), and we aim to find potential prognostic biomarkers for HCC patients who received SBRT.Methods: In this study, we retrospectively analyzed HCC patients who underwent SBRT in our institution from January 2018 to December 2022. The inflammatory parameters, along with baseline patients’ characteristics were collected to elucidate the potential relationship with survival benefits and liver toxicities.Results: Overall, 35 patients were enrolled in our study. For the efficacy population (25 patients who underwent SBRT for primary liver lesions), the objective response rate (ORR) and disease control rate (DCR) were 60% and 100%, respectively. The median progression-free survival (PFS) was 9.9 months [95% confidence interval (CI) 5.6– 14.1 months], and the median overall survival (OS) was 18.5 months (95% CI 14.2– 22.8 months). We further confirmed that higher baseline lymphocyte-C-reactive protein ratio (LCR) (≥ 2361.11) was positively related to both longer PFS (12.0 vs 4.3 months, P = 0.002) and OS (21.9 vs 11.4 months, P = 0.022). Moreover, patients with diabetes and higher alpha-fetoprotein (AFP) (≥ 400 ng/mL) were also found to be associated with worse OS. The most common hepatotoxicity was elevated gamma-glutamyl transferase (GGT) (84.0%).Conclusion: In conclusion, for patients with inoperable HCC, SBRT resulted in satisfactory local control, survival benefits, and acceptable liver toxicity. Pre-radiotherapy LCR might be an independent and readily available predictor for survival, which facilitates us to find the most appropriate treatment options.Keywords: hepatocellular carcinoma, stereotactic body radiotherapy, lymphocyte-C-reactive  protein  ratio, survival, liver toxicityhttps://www.dovepress.com/lymphocyte-to-c-reactive-protein-ratio-is-an-independent-predictor-of--peer-reviewed-fulltext-article-JHChepatocellular carcinomastereotactic body radiotherapylymphocyte-c-reactive protein ratiosurvivalliver toxicity.
spellingShingle Shi Z
Zhu S
Jin Y
Qi L
Zhou M
Zhou Z
Zhang J
Liu B
Shen J
Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy
Journal of Hepatocellular Carcinoma
hepatocellular carcinoma
stereotactic body radiotherapy
lymphocyte-c-reactive protein ratio
survival
liver toxicity.
title Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy
title_full Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy
title_fullStr Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy
title_full_unstemmed Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy
title_short Lymphocyte-to-C Reactive Protein Ratio is an Independent Predictor of Survival Benefits for Hepatocellular Carcinoma Patients Receiving Radiotherapy
title_sort lymphocyte to c reactive protein ratio is an independent predictor of survival benefits for hepatocellular carcinoma patients receiving radiotherapy
topic hepatocellular carcinoma
stereotactic body radiotherapy
lymphocyte-c-reactive protein ratio
survival
liver toxicity.
url https://www.dovepress.com/lymphocyte-to-c-reactive-protein-ratio-is-an-independent-predictor-of--peer-reviewed-fulltext-article-JHC
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