Luo Hui, Ge Hong, Cui Yingying, Zhang Jiangong, Fan Ruitai, Zheng Anping, Zheng Xiaoli, Sun Yanan
Division of Graduate, The Second Clinical Medical School and the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
J Cancer. 2018 Jan 1;9(1):182-188. doi: 10.7150/jca.21703. eCollection 2018.
Increasing evidence indicates a relationship between systemic inflammation and survival following treatment in various tumors. However, the correlation of systematic inflammation with survival after stereotactic ablative radiotherapy (SABR) in early stage non-small cell lung cancer (NSCLC) has not been well established. We retrospectively analyzed patients with newly diagnosed early stage NSCLC treated with SABR in a single institution from 2011 to 2015. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte- monocyte ratio (LMR) were calculated as systemic inflammation biomarkers. Overall survival (OS) was the first end-point. Receiver operating characteristic (ROC) was used to determine cut-off points for OS. Univariate and multivariate Cox proportional hazards regression were used to investigate the potential factors associated with OS. In the 63 patients who were eligible for analysis. The median follow up after SBRT was 29.5 months (range 8-67 months) while the 3-year OS was 74.2%. Based on ROC analysis, optimal cut-off values of NLR, PLR, and LMR were 2.06, 199.55 and 4.0, respectively. Significant survival benefit was found in the NLR ≤2.06 group (p=0.028), PLR≤199.55 group (p=0.001), and LMR˃4.0 group (p=0.046). Univariate analysis indicated that low NLR (p=0.011), low PLR (p=0.003), and high LMR (p=0.014) were correlated with improved survival. Multivariate analysis indicated that high PLR (p=0.033) and low LMR (p=0.046) were independent prognostic factors for poor survival. In patients of early stage NSCLC who received SABR, pretreatment NLR, PLR, and LMR could be considered useful prognostic indicators of OS. These metrics may provide reliable and convenient predictors to identify patients who would benefit from SABR.
越来越多的证据表明，全身炎症与各种肿瘤治疗后的生存率之间存在关联。然而，在早期非小细胞肺癌（NSCLC）中，全身炎症与立体定向消融放疗（SABR）后生存率的相关性尚未明确确立。我们回顾性分析了2011年至2015年在单一机构接受SABR治疗的新诊断早期NSCLC患者。计算中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及淋巴细胞与单核细胞比值（LMR）作为全身炎症生物标志物。总生存期（OS）是首要终点。采用受试者工作特征（ROC）曲线确定OS的截断点。使用单因素和多因素Cox比例风险回归来研究与OS相关的潜在因素。在符合分析条件的63例患者中。立体定向体部放疗（SBRT）后的中位随访时间为29.5个月（范围8 - 67个月），3年总生存率为74.2%。基于ROC分析，NLR、PLR和LMR的最佳截断值分别为2.06、199.55和4.0。在NLR≤2.06组（p = 0.028）、PLR≤199.55组（p = 0.001）和LMR˃4.0组（p = 0.046）中发现了显著的生存获益。单因素分析表明，低NLR（p = 0.011）、低PLR（p = 0.003）和高LMR（p = 0.014）与生存率提高相关。多因素分析表明，高PLR（p = 0.033）和低LMR（p = 0.046）是生存不良的独立预后因素。在接受SABR的早期NSCLC患者中，治疗前的NLR、PLR和LMR可被视为OS的有用预后指标。这些指标可能为识别将从SABR中获益的患者提供可靠且便捷的预测指标。
