Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Oral Dis. 2020 Oct;26(7):1384-1392. doi: 10.1111/odi.13366. Epub 2020 May 13.
To evaluate the role of baseline neutrophil-to-lymphocyte ratio (NLR) as prognostic marker in squamous cell carcinoma of the oropharynx (OPC) treated with definitive chemoradiotherapy (CRT) in the era of HPV status.
A retrospective analysis of 125 patients (pts) affected with locally advanced OPC was performed. Inclusion criteria were age >18 years, stage III or IV (TNM 7th ed.) and definitive CRT. Haematological marker for their independent role as prognostic biomarkers for progression-free survival (PFS) and overall survival (OS). Logistic models were used to assess the association with downstage in TNM 8th ed.
Seventy-seven (61.6%) pts had HPV/p16 + related OPC. Therapeutic choice consisted in sequential and concurrent CRT. Median follow-up was 50 months. A value of NLR ≥3 was associated with poorer OS. Two-year OS was 91% and 81% in pts with NLR <3 and ≥3, respectively.
A baseline NLR ≥ 3 at treatment initiation represented a negative prognostic marker for OPC treated with definitive CRT. These results are in line with literature data, and prognostic value of NLR has been confirmed restaging our cohort with new TNM staging (8th ed.). Therefore, NLR could be considered a valuable biomarker for risk stratification in pts with OPC.
评估基线中性粒细胞与淋巴细胞比值（NLR）在 HPV 状态时代接受根治性放化疗（CRT）治疗的口咽鳞状细胞癌（OPC）患者中的预后标志物作用。
对 125 例局部晚期 OPC 患者进行回顾性分析。纳入标准为年龄>18 岁、III 或 IV 期（TNM 第 7 版）和根治性 CRT。血液学标志物作为无进展生存（PFS）和总生存（OS）的独立预后生物标志物。使用逻辑模型评估与第 8 版 TNM 降期的关联。
77 例（61.6%）患者患有 HPV/p16+相关的 OPC。治疗选择包括序贯和同期 CRT。中位随访时间为 50 个月。NLR≥3 与较差的 OS 相关。NLR<3 和 NLR≥3 的患者 2 年 OS 分别为 91%和 81%。
治疗开始时基线 NLR≥3 是接受根治性 CRT 治疗的 OPC 的负面预后标志物。这些结果与文献数据一致，并且 NLR 的预后价值在使用新的 TNM 分期（第 8 版）重新分期我们的队列时得到了证实。因此，NLR 可以被认为是 OPC 患者风险分层的有价值的生物标志物。
