title: Pre-treatment neutrophil-to-lymphocyte ratio predicts prognosis in patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of neutrophil-to-lymphocyte ratio on the prognosis of patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy.
  
  
  METHODS
  One hundred and twenty-five patients with locoregionally advanced laryngeal carcinoma (cT3-4 N0-3M0) treated with chemoradiotherapy were reviewed retrospectively. Chemoradiotherapy comprised external beam radiotherapy to the larynx (70 Gy) with three cycles of cisplatin at 3 week intervals. The survival rate was calculated using the Kaplan-Meier method, and a multivariate analysis was used to identify significant factors associated with prognosis, using a Cox proportional hazards model.
  
  
  RESULTS
  During the median (range) follow-up of 45 months, the median neutrophil-to-lymphocyte ratio was 3.02. The high neutrophil-to-lymphocyte ratio group (neutrophil-to-lymphocyte ratio > 3.0) contained 69 patients and the low neutrophil-to-lymphocyte ratio group (neutrophil-to-lymphocyte ratio < 3.0) contained 46 patients. The low neutrophil-to-lymphocyte ratio group patients had a significantly higher chemoradiotherapeutic disease control rate (86.96 vs. 69.57%, P = 0.031). Forty-six patients had a low neutrophil-to-lymphocyte ratio (<3.0) before chemoradiotherapy and their progression-free survival and 75% overall survival were significantly better than that of the high neutrophil-to-lymphocyte ratio patients (P = 0.015, P = 0.045). Multivariate analysis showed that neutrophil-to-lymphocyte ratio and N stage were independent prognostic indicators for progression-free survival (with a hazard ratio of 1.79, P = 0.003 and a hazard ratio of 1.28, P = 0.034) and overall survival (with a hazard ratio of 1.51, P = 0.029 and a hazard ratio of 1.21, P = 0.043), respectively.
  
  
  CONCLUSIONS
  Pre-treatment neutrophil-to-lymphocyte ratio is a useful prognostic marker in patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy.
authors.affiliation: Department of Medical Oncology, Cancer Center, Shengjing Hospital of China Medical University, Shenyang.
authors.forename: Yue-Can
authors.initials: YC
authors.lastname: Zeng
authors.affiliation: Department of Medical Oncology, Cancer Center, Shengjing Hospital of China Medical University, Shenyang.
authors.forename: Feng
authors.initials: F
authors.lastname: Chi
authors.affiliation: Department of Medical Oncology, Cancer Center, Shengjing Hospital of China Medical University, Shenyang.
authors.forename: Rui
authors.initials: R
authors.lastname: Xing
authors.affiliation: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xue
authors.affiliation: Department of Medical Oncology, Cancer Center, Shengjing Hospital of China Medical University, Shenyang.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Wu
authors.affiliation: Department of Medical Oncology, Cancer Center, Shengjing Hospital of China Medical University, Shenyang.
authors.forename: Mei-Yue
authors.initials: MY
authors.lastname: Tang
authors.affiliation: Department of Medical Oncology, Cancer Center, Shengjing Hospital of China Medical University, Shenyang 511695796@qq.com wur@sj-hospital.org.
authors.forename: Rong
authors.initials: R
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000628:therapy*; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D002945:Cisplatin
keywords: chemoradiotherapy; laryngeal carcinoma; neutrophil-to-lymphocyte ratio; progression-free survival