Prognostic value of parameters derived from white blood cell and differential counts in patients receiving palliative radiotherapy.
The aim of the present study was to identify white blood cell (WBC) parameters with high prognostic value for the survival of patients receiving palliative radiotherapy. The prognostic value of seven parameters derived from WBC and differential counts was retrospectively evaluated in patients who underwent palliative radiotherapy between October, 2010 and June, 2013. The analyzed parameters were the total WBC count, the absolute and relative lymphocyte count, the absolute and relative neutrophil count, and the neutrophil-to-lymphocyte and lymphocyte-to-monocyte ratios. Following univariate analysis, multivariate Cox regression analysis was performed to adjust for gender, age, disease type, previous chemotherapy, previous radiotherapy and the levels of albumin and lactate dehydrogenase. A total of 220 patients with a median survival of 4.7 months were identified. All seven parameters were found to be statistically significant predictors of survival on univariate Cox regression analysis (P<0.05). Of these parameters, the low relative lymphocyte and high relative neutrophil counts were consistent predictors of poor survival in patients who received chemotherapy within 1 month prior to blood sampling (n=68) and in patients who received steroid treatment at the time of sampling (n=49). Multivariate Cox regression analysis revealed that the relative lymphocyte and neutrophil counts were independent predictors of survival in all 220 patients (P<0.05). In conclusion, relative lymphocyte and neutrophil counts were of high prognostic value for the survival of patients receiving palliative radiotherapy, even in those receiving medications that affect WBC and differential counts.
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
Tetsuo
T
Saito
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto 860-8556, Japan; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
Ryo
R
Toya
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
Tomohiko
T
Matsuyama
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
Akiko
A
Semba
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
Keiya
K
Matsuyama
Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
Natsuo
N
Oya
overall survival; palliative radiotherapy; prediction of survival; prognostic factor; white blood cell parameters