Dynamic evaluation of neutrophil-to-lymphocyte ratio as prognostic factor in stage III non-small cell lung cancer treated with chemoradiotherapy

V. Palomar Abril; T. Soria Comes; Sonia Tarazona Campos; María Martín Ureste; Vicent Giner Bosch; Inmaculada Maestu Maiques

Ayuda

Dynamic evaluation of neutrophil-to-lymphocyte ratio as prognostic factor in stage III non-small cell lung cancer treated with chemoradiotherapy

V. Palomar-Abril ^[1] ; T. Soria-Comes ^[1] ; S. T. Campos ^[2] ; M. M. Ureste ^[1] ; V. G. Bosch ^[2] ; I. C. M. Maiques ^[1]
1. [1] Hospital Universitario Doctor Peset
  
  Hospital Universitario Doctor Peset
  
  Valencia, España
2. [2] Universidad Politécnica de Valencia
  
  Universidad Politécnica de Valencia
  
  Valencia, España
Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 12 (December), 2020, págs. 2333-2340
Idioma: inglés
DOI: 10.1007/s12094-020-02396-6
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Resumen
- Purpose Locally advanced non-small cell lung cancer (LA-NSCLC) is frequently treated with chemoradiotherapy (CRT). Despite the efforts, long-term outcomes are poor, and novel therapies have been introduced to improve results. Biomarkers are needed to detect early treatment failure and plan future follow-up and therapies. Our aim is to evaluate the role of dynamics of neutrophil-to-lymphocyte ratio (NLR) in patients with locally advanced NSCLC treated with CRT.
  
  Methods We retrospectively reviewed patients diagnosed with LA-NSCLC receiving definitive CRT at our center from 2010 to 2015. Baseline and post-treatment NLR were collected from our center database. NLR was dichotomized (threshold = 4) and patients were divided into two groups based on the variation from baseline to post-treatment NLR. The prognostic role and association with response were examined with logistic regression and multivariate Cox regression model, respectively.
  
  Results Ninety-two patients were included. Our analysis shows that NLR after treatment is associated with response to treatment [OR in the multivariate analysis 4.94 (1.01–24.48); p value = 0.048]. Furthermore, NLR and ECOG are independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Specifically, PFS was 25.79 months for the good prognosis group and 12.09 for the poor prognosis group [HR 2.98 (CI 95% = 1.74–5.10), p < 0.001]; and OS was 42.94 months and 18.86 months, respectively [HR 2.81 (CI 95% = 1.62–4.90), p < 0.001].
  
  Conclusion Dynamics of NLR have a prognostic value in stage III NSCLC treated with definitive CRT. Pre- and post-CRT NLR should be evaluated in prospective clinical trials involving consolidation treatment with immunotherapy.