The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Eur J Cancer. 2012 Jan;48(2):202-8. doi: 10.1016/j.ejca.2011.09.001. Epub 2011 Oct 19.
Sunitinib is a standard treatment for metastatic renal cell carcinoma (mRCC). The neutrophil to lymphocyte ratio (NLR), an index of systemic inflammation, is associated with outcome in several cancer types.
To study the association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival (PFS) and overall survival (OS) of patients treated with sunitinib for mRCC.
We retrospectively studied an unselected cohort of patients with mRCC, who were treated with sunitinib. Logistic regression model was used to analyse response rate. Cox regression models were fitted to identify risk factors associated with PFS and OS. We investigated how pre-treatment NLR is associated with these clinical outcomes after adjusting for confounding covariates. Regression tree for censored data method was used to find the best NLR cut-off value.
Between 2004 and 2011, 133 patients with mRCC were treated with sunitinib. One hundred and nine were included in the NLR analysis, from which were excluded patients without available data on pre-treatment NLR or with comorbidities/recent treatments known to be associated with a change of blood counts. Factors associated with PFS were low NLR ≤ 3 (HR = 0.285, p < 0.001), past nephrectomy (HR = 0.38, p = 0.035), sunitinib dose reduction/treatment interruption (HR = 0.6, p = 0.014) and the use of antiotensin system inhibitors (HR = 0.537, p = 0.008). Low NLR ≤ 3 was associated with OS (HR = 0.3, p = 0.043).
In patients with mRCC treated with sunitinib, pre-treatment NLR may be associated with PFS and OS. This should be investigated prospectively, and if validated applied in clinical practice and clinical trials.
舒尼替尼是转移性肾细胞癌（mRCC）的标准治疗方法。中性粒细胞与淋巴细胞比值（NLR）是全身炎症的指标，与几种癌症类型的预后相关。
研究 mRCC 患者接受舒尼替尼治疗前 NLR 与缓解率、无进展生存期（PFS）和总生存期（OS）的相关性。
我们回顾性研究了一组未经选择的 mRCC 患者，他们接受了舒尼替尼治疗。Logistic 回归模型用于分析缓解率。Cox 回归模型用于确定与 PFS 和 OS 相关的风险因素。我们在调整混杂因素后，研究了治疗前 NLR 与这些临床结果的相关性。用于分析删失数据的回归树方法用于确定最佳 NLR 截断值。
在 2004 年至 2011 年间，共有 133 名 mRCC 患者接受了舒尼替尼治疗。其中 109 名患者的 NLR 分析纳入研究，排除了未提供治疗前 NLR 数据或存在已知会影响血液计数变化的合并症/近期治疗的患者。与 PFS 相关的因素包括 NLR≤3（HR=0.285，p＜0.001）、既往肾切除术（HR=0.38，p=0.035）、舒尼替尼剂量减少/治疗中断（HR=0.6，p=0.014）和血管紧张素系统抑制剂的使用（HR=0.537，p=0.008）。NLR≤3 与 OS 相关（HR=0.3，p=0.043）。
在接受舒尼替尼治疗的 mRCC 患者中，治疗前 NLR 可能与 PFS 和 OS 相关。这应该在未来进行前瞻性研究，如果得到验证，可应用于临床实践和临床试验。
