Homa-Mlak Iwona, Brzozowska Anna, Mlak Radosław, Szudy-Szczyrek Aneta, Małecka-Massalska Teresa
Department of Human Physiology, Medical University of Lublin, Radziwiłłowska 11, 20-080 Lublin, Poland.
Department of Oncology, Medical University of Lublin, Jaczewskiego 7, 20-090 Lublin, Poland.
J Clin Med. 2021 Sep 27;10(19):4444. doi: 10.3390/jcm10194444.
The objective of this research conducted in head and neck cancer (HNC) patients was the assessment of the relationship between neutrophil-to-lymphocyte ratio (NLR) and the incidence of severe radiotherapy (RT) induced oral mucositis (OM), as well as overall survival (OS).
The study involved 207 patients in advanced stages (III-IV) of HNC. RTOG/EORTC scale was used to assess OM. The pre-treatment NLR was specified as the absolute neutrophil count divided by the absolute lymphocyte count.
Starting from second to seventh week of RT, we observed a significant, positive correlation between NLR values and OM grade. From the second to seventh week of RT, higher NLR values were related with significant increases (from 2- to over 24-fold) in the risk of occurrence of more severe OM (multivariate analysis confirmed its independent influence). Moreover, multivariate analysis for survival revealed that both higher TNM stage (HR = 1.84; = 0.0043) and higher NLR values (HR = 1.48; = 0.0395) were independent prognostic factors.
NLR is a simple and accurate parameter that is useful in the evaluation of the risk of more severe OM, as well as an independent prognostic factor of OS in patients subjected to RT due to HNC.
本研究针对头颈癌（HNC）患者开展，旨在评估中性粒细胞与淋巴细胞比值（NLR）与重度放疗（RT）诱发的口腔黏膜炎（OM）发生率以及总生存期（OS）之间的关系。
该研究纳入了207例晚期（III-IV期）头颈癌患者。采用RTOG/EORTC量表评估口腔黏膜炎。治疗前的NLR定义为绝对中性粒细胞计数除以绝对淋巴细胞计数。
从放疗的第二周持续至第七周，我们观察到NLR值与口腔黏膜炎分级之间存在显著的正相关。在放疗的第二周持续至第七周，较高的NLR值与更严重口腔黏膜炎发生风险显著增加（2至超过24倍）相关（多因素分析证实了其独立影响）。此外，生存情况的多因素分析显示，较高的TNM分期（HR = 1.84；P = 0.0043）和较高的NLR值（HR = 1.48；P = 0.0395）均为独立的预后因素。
NLR是一个简单且准确的参数，有助于评估更严重口腔黏膜炎的风险，也是因头颈癌接受放疗患者总生存期的独立预后因素。
