Prognostic value of posttreatment neutrophil-lymphocyte ratio in head and neck squamous cell carcinoma treated by chemoradiotherapy.
OBJECTIVE
An inflammatory-immunological marker, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), was evaluated as a predictive marker of advanced head and neck cancer patients receiving chemoradiotherapy.


METHODS
This study included 104 patients with treatment-naïve head and neck cancer who underwent definitive chemoradiotherapy. An inflammatory marker was measured at baseline and after 1 month of treatment. Univariate and multivariate analyses using Cox proportional hazards model were used to identify predictors of progression-free survival (PFS) and overall survival (OS).


RESULTS
A univariate analysis revealed that T,N-stage, the pre- and posttreatment NLRs were significant predictors of progression after the chemoradiotherapy. However, the posttreatment NLR remained an independent predictor of PFS in the multivariate analysis (HR=2.23, 95% CI 1.15-2.321; P=0.001). A high posttreatment NLR was significantly associated with an increased risk of death (HR=1.87, 95% CI 0.89-3.31; P=0.037).


CONCLUSIONS
A high posttreatment NLR is associated with poor prognostic factor. An early reduction in the NLR after treatment may indicate survival improvement in the patients.
Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
Do Young
DY
Kim
Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
In Su
IS
Kim
Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
Sang Gyu
SG
Park
Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
Hyojeong
H
Kim
Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
Young Jin
YJ
Choi
Department of Hematology-Oncology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea. Electronic address: seol2100@hanmail.net.
Young Mi
YM
Seol
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000378:metabolism / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000166:cytology*; D011379:Prognosis; D016016:Proportional Hazards Models; D000077195:Squamous Cell Carcinoma of Head and Neck
D000970:Antineoplastic Agents; D002097:C-Reactive Protein; D002945:Cisplatin
Chemoradiotherapy; Head and neck squamous cell carcinomas; Neutrophil–lymphocyte ratio; Prognosis