Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, USA.
Department of Radiation Oncology, Massachusetts General Hospital, Boston, USA.
Radiother Oncol. 2019 May;134:151-157. doi: 10.1016/j.radonc.2019.01.032. Epub 2019 Feb 15.
Neutrophil-lymphocyte ratio (NLR) has been associated with mortality in several disease sites. We hypothesized that NLR is associated with inferior outcomes in localized non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT).
We evaluated the association of pre-treatment NLR, obtained within 6 months of starting SBRT, with overall survival, as well as primary tumor, regional, and distant recurrence. Multivariate Cox regression was then used to assess pre-treatment NLR as a predictor of mortality. We validated our findings in an independent cohort of patients treated at two other institutions. In a secondary analysis, we also evaluated the association of post-treatment NLR with mortality in the training cohort.
A total of 156 patients and 166 tumors were included in the training cohort with a median follow-up of 13.4 months. After dichotomization by median, NLR > 3.6 was associated with mortality on univariate (p = 0.010) and multivariate analysis (p = 0.023). In the validation cohort, NLR > 3.6 was similarly associated with mortality on univariate (p = 0.031) and multivariate (p = 0.007) analysis. In a secondary analysis in the training cohort, we found post-treatment NLR was significantly increased compared to pre-treatment NLR (p < 0.001) and associated with mortality on univariate analysis (p = 0.005) and multivariate analysis (p = 0.010).
Pre-treatment NLR > 3.6 is associated with mortality in patients treated with SBRT. This finding was validated in an independent cohort of patients treated at two other institutions. Additionally, post-treatment NLR was significantly increased from pre-treatment and associated with overall survival.
中性粒细胞与淋巴细胞比值（NLR）与多个疾病部位的死亡率相关。我们假设 NLR 与接受立体定向体部放射治疗（SBRT）的局限性非小细胞肺癌（NSCLC）患者的不良预后相关。
我们评估了治疗开始前 6 个月内获得的 NLR 与总生存率以及原发性肿瘤、区域性和远处复发的相关性。然后，我们使用多变量 Cox 回归评估 NLR 作为死亡率的预测指标。我们在另外两家机构治疗的患者的独立队列中验证了我们的发现。在二次分析中，我们还评估了治疗后 NLR 与训练队列死亡率的相关性。
训练队列共纳入 156 例患者和 166 个肿瘤，中位随访时间为 13.4 个月。通过中位数进行二分法后，NLR＞3.6 在单因素（p=0.010）和多因素分析（p=0.023）中与死亡率相关。在验证队列中，NLR＞3.6 在单因素（p=0.031）和多因素分析（p=0.007）中也与死亡率相关。在训练队列的二次分析中，我们发现治疗后 NLR 与治疗前 NLR 相比显著升高（p＜0.001），且与单因素分析（p=0.005）和多因素分析（p=0.010）中的死亡率相关。
治疗前 NLR＞3.6 与接受 SBRT 治疗的患者的死亡率相关。这一发现在另外两家机构治疗的患者的独立队列中得到了验证。此外，治疗后 NLR 与治疗前相比显著升高，与总生存率相关。
