Increasing neutrophil-to-lymphocyte ratio following radiation is a poor prognostic factor and directly correlates with splenic radiation dose in pancreatic cancer

Wolfe, Adam R.; Siedow, Michael; Nalin, Ansel P.; DiCostanzo, D.J.; Miller, Eric D.; Diaz, Dayssy Alexandra; Arnett, A.L.H.; Cloyd, Jordan M.; Dillhoff, Mary; Ejaz, Aslam; Tsung, Allan; Williams, Terence M.

doi:10.1016/j.radonc.2021.02.035

Cited by 16 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most previous studies have selected the cutoff values of inflammatory markers based on receiver operating characteristics (ROC) curves, 15,16 which intuitively represents the sensitivity and specificity of various cutoff values. In the present study, we generated ROC curves, then selected the optimal cutoff values based on the Youden Index.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Inflammatory Markers in Nasopharyngeal Carcinoma Patients in the Intensity-Modulated Radiotherapy Era

Yang

et al. 2021

CMAR

View full text Add to dashboard Cite

Purpose: Inflammatory markers have been widely used in various cancers, but rarely in nasopharyngeal carcinoma (NPC). Here, we evaluated the prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte-ratio (PLR), systemic immune index (SII), and systemic inflammation response index (SIRI) on NPC in the intensitymodulated radiotherapy (IMRT) era. Methods: We retrospectively analyzed data from NPC patients from the Renmin Hospital of Wuhan University, between January 2012 and July 2020. We used Chi-square test or Fisher's exact test to compare the baseline characteristics, then applied Kaplan-Meier (K-M) survival analysis to compare the overall survival (OS) and progression-free survival (PFS) rates. Multivariate Cox proportional risk models were applied to identify independent prognostic factors. Results: We enrolled a total of 342 NPC patients and found optimal cut-off values of 2.65, 184.91, 804.08, and 1.34 for NLR, PLR, SII, and SIRI, respectively. K-M survival analysis revealed that high NLR, PLR, SII, and SIRI were significantly associated with worse OS and PFS relative to those in the low groups. Results from univariate Cox analysis showed that clinical, T, and M stages, as well as NLR, PLR, SII, and SIRI were associated with OS, whereas age, alongside the aforementioned parameters, was associated with PFS. Moreover, multivariate Cox analysis showed that age ≥49 years (HR=2.48, 95% CI=1.21-5.05, P=0.013) and M1 stage (HR=3.84, 95% CI=1.52-9.73, P=0.013) were independent prognostic factors for OS, whereas SIRI ≥1.34 (HR=1.91, 95% CI=1.05-3.47, P=0.034) and M1 stage (HR=2.91, 95% CI=1.44-5.86, P=0.003) were independent prognostic factors for PFS. Conclusion: Overall, our findings indicated that high NLR, PLR, SII, and SIRI were significantly associated with poor OS and PFS in NPC patients. High SIRI may be an independent risk factor for PFS of NPC patients in the IMRT era.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Inflammatory Markers in Nasopharyngeal Carcinoma Patients in the Intensity-Modulated Radiotherapy Era

Yang

et al. 2021

CMAR

View full text Add to dashboard Cite

show abstract

“…25,26 The neutrophils and platelets are moderately radiosensitive, and erythrocytes are the most radioresistant hematologic cells. Recently, Wolfe et al 13 reported that in patients with locally advanced pancreatic cancer treated with neoadjuvant therapy, lymphocyte counts showed a pronounced decline following conventional radiotherapy (36 or 50.4 Gy) compared to neutrophil counts (peri-RT percentage change, −45.1% vs −18.7%), resulting in a marked increase in NLR by 99.7%. In another study by Zhuang et al, a decrease in circulating blood cells was noted in 50 patients receiving SBRT of 48-60 Gy for small HCC.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Dynamic changes in inflammatory markers may reflect host immune response to therapy and help predict treatment outcomes. 12,13 Accordingly, dynamic inflammatory status and host immune response, with other clinicopathologic features, may aid in therapeutic decision-making.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Changes in Neutrophil-to-Lymphocyte Ratio are Associated with Survival and Liver Toxicity Following Stereotactic Body Radiotherapy for Hepatocellular Carcinoma

Hsiang¹,

Huang²,

Yang³

et al. 2021

JHC

View full text Add to dashboard Cite

“…These studies suggest that NLR, which takes into account both neutrophils and lymphocytes, may serve as a prognostic measure in pancreatic cancer treated with radiation therapy. However, until now, few studies have investigated the prognostic role of post-radiation NLR, as opposed to preradiation NLR, given that the former may serve as a better measure of immunologic impact of radiation therapy for pancreatic cancer (27)(28)(29)(30)(31). A study by Pearson et al, published in abstract form, represents the only prior report on post-radiation NLR and found that post-SBRT NLR, and not pre-SBRT NLR, was predictive of OS (30).…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic value of NLR in pancreatic cancer treated with radiation therapy has been investigated in only a handful of reports (27)(28)(29)(30)(31). Current studies are limited by heterogeneity in clinical outcomes, radiation dose/ fractionation, and time point of NLR (i.e., pre-radiation or post-radiation).…”

Section: Introductionmentioning

confidence: 99%

High neutrophil-to-lymphocyte ratio following stereotactic body radiation therapy is associated with poor clinical outcomes in patients with borderline resectable and locally advanced pancreatic cancer

Reddy¹,

Hill²,

Sehgal³

et al. 2022

J Gastrointest Oncol

View full text Add to dashboard Cite

Background: The purpose of this study is to report on the prognostic role of pre-and post-stereotactic body radiation therapy (SBRT) neutrophil-to-lymphocyte ratio (NLR) in a cohort of patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) who was treated with multiagent induction chemotherapy followed by five-fraction SBRT.Methods: Patients treated with multi-agent induction chemotherapy followed by SBRT from August 2016 to January 2019 and who had laboratory values available for review were included in the study. Univariate (UVA) and multivariate analyses (MVA) were performed to determine associations between pre-/post-SBRT NLR and overall survival (OS), local progression-free survival (LPFS), distant metastasis-free survival (DMFS), and progression-free survival (PFS).Results: A total of 156 patients were treated with multi-agent induction chemotherapy followed by SBRT and had laboratory values available for review. On UVA, chemotherapy duration ≥4 months, poorly differentiated disease, inability to undergo resection, pre-SBRT ANC ≥3.7 no./μL, pre-SBRT NLR ≥2.3, and post-SBRT NLR ≥2.6 were associated with worse OS. Patients with post-SBRT NLR ≥2.6 had a median OS of 16.7 months versus median OS not yet reached in patients with post-SBRT <2.6 (P=0.009).

show abstract

Increasing neutrophil-to-lymphocyte ratio following radiation is a poor prognostic factor and directly correlates with splenic radiation dose in pancreatic cancer

Cited by 16 publications

References 27 publications

Prognostic Value of Inflammatory Markers in Nasopharyngeal Carcinoma Patients in the Intensity-Modulated Radiotherapy Era

Prognostic Value of Inflammatory Markers in Nasopharyngeal Carcinoma Patients in the Intensity-Modulated Radiotherapy Era

Dynamic Changes in Neutrophil-to-Lymphocyte Ratio are Associated with Survival and Liver Toxicity Following Stereotactic Body Radiotherapy for Hepatocellular Carcinoma

High neutrophil-to-lymphocyte ratio following stereotactic body radiation therapy is associated with poor clinical outcomes in patients with borderline resectable and locally advanced pancreatic cancer

Contact Info

Product

Resources

About