title: Pre-radiotherapy neutrophil-to-lymphocyte ratio as an independent prognostic factor in patients with locally advanced hepatocellular carcinoma treated with radiotherapy.
abstract: We aimed to investigate the pre-radiotherapy neutrophil-to-lymphocyte ratio (prNLR) as a prognostic factor in patients with locally advanced hepatocellular carcinoma (HCC) treated with radiotherapy (RT), and to determine the optimal cut-off value for prNLR. We retrospectively evaluated 56 patients with locally advanced HCC treated with RT (helical tomotherapy) between March 2006 and February 2012. The optimal cut-off value was determined by using a maximally selected log-rank test. Prognostic factors that influence the local progression-free survival (PFS) and overall survival (OS) were evaluated. A prNLR of 2.1 was determined to be the optimal cut-off value. In a comparison between the high-prNLR group and the low-prNLR group, there was a 13.1-month difference in the median OS (10.3 vs. 23.4 months, p = 0.003) and a 10.4-month difference in the median local PFS (7.1 vs. 17.5 months, p = 0.001). On multivariate analysis of prognostic factors for local PFS and OS, the prNLR was identified as an independent prognostic factor, and the hazard ratio was 4.2 and 2.5, respectively. We demonstrated that a low prNLR was significantly associated with better PFS and OS in patients with locally advanced HCC treated with RT, and the prNLR should be considered as an independent prognostic factor in these patients.
authors.affiliation: Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seok Hyun
authors.initials: SH
authors.lastname: Son
authors.affiliation: Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hee Hyun
authors.initials: HH
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chul Seung
authors.initials: CS
authors.lastname: Kay
authors.affiliation: Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Jang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
keywords: hepatocellular carcinoma; neutrophil-to-lymphocyte ratio; radiotherapy