Faculty of Medicine, Department of Radiation Oncology, Baskent University, Ankara, Turkey.
Faculty of Medicine, Adana Dr. Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Baskent University, 01120, Adana, Turkey.
Strahlenther Onkol. 2024 Nov;200(11):949-957. doi: 10.1007/s00066-024-02278-8. Epub 2024 Aug 5.
This study sought to determine the predictive and prognostic value of clinicopathological parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin (Hgb) level in predicting recurrence patterns and locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) in cervical cancer patients receiving definitive chemoradiotherapy (ChRT).
This study included 261 cervical cancer patients treated with ChRT. The primary endpoints were the predictors of local recurrence (LR) and distant metastasis (DM), whereas the secondary endpoints were LRFS and DMFS. The association of survival with potential prognostic factors was analyzed using Cox regression analysis, and the predictors of LR and DM were identified using logistic regression analysis.
The median follow-up time was 10.9 years. Recurrences occurred in 132 patients (50.6%) within a median of 11.2 months after definitive ChRT. NLR and PLR values were significantly higher in patients with LR and DM than in those without, with no significant differences in Hgb levels in patients with or without LR and DM. In the multivariable logistic regression analysis, lymph node metastasis, elevated NLR, and low Hgb level were significantly correlated with LR and DM. In the multivariable analysis, large tumor size, presence of lymph node metastasis, and elevated NLR were the independent predictors for poor LRFS and DMFS, and Hgb level was an additional prognostic factor for DMFS.
Hematological markers, particularly NLR and Hgb, may serve as cost-effective and readily accessible indicators for predicting recurrence and survival in cervical cancer patients, contributing to their practical use in routine assessments.
本研究旨在确定临床病理参数以及中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和血红蛋白（Hgb）水平在预测接受根治性放化疗（ChRT）的宫颈癌患者复发模式和局部无复发生存（LRFS）及远处无转移生存（DMFS）方面的预测价值和预后价值。
本研究纳入了 261 例接受 ChRT 的宫颈癌患者。主要终点是局部复发（LR）和远处转移（DM）的预测因素，次要终点是 LRFS 和 DMFS。采用 Cox 回归分析评估生存与潜在预后因素的相关性，采用逻辑回归分析确定 LR 和 DM 的预测因素。
中位随访时间为 10.9 年。在根治性 ChRT 后中位 11.2 个月内，132 例患者（50.6%）出现复发。LR 和 DM 患者的 NLR 和 PLR 值显著高于无 LR 和 DM 患者，而 Hgb 水平在有或无 LR 和 DM 患者之间无显著差异。多变量逻辑回归分析显示，淋巴结转移、NLR 升高和 Hgb 水平降低与 LR 和 DM 显著相关。多变量分析显示，大肿瘤大小、淋巴结转移存在和 NLR 升高是 LRFS 和 DMFS 不良的独立预测因素，而 Hgb 水平是 DMFS 的另一个预后因素。
血液学标志物，特别是 NLR 和 Hgb，可能成为预测宫颈癌患者复发和生存的具有成本效益且易于获得的指标，有助于在常规评估中实际应用。
