Neutrophil–Lymphocyte and Platelet–Lymphocyte Ratios as Prognostic Factors after Stereotactic Radiation Therapy for Early-Stage Non–Small-Cell Lung Cancer

Abstract

The pretreatment NLR and PLR represented significant prognostic indicators of survival in patients treated for early-stage non-small-cell lung carcinoma with stereotactic radiation. The PLR may be used as a prognostic indicator for nonlocal failure after stereotactic radiation for early-stage lung cancer.

Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

“…Because high-dose radiation has been shown to alter cells associated with pro-and antitumour immunity 31 , investigating the interplay between dose and these cell ratios is also justified. Finally, cbc within 3 months of sbrt, as chosen for the present study, is consistent with other radiotherapy analyses of nlr and mlr 5,11 ; however, the degree to which neutrophils, monocytes, and lymphocytes can change within that time period is not known.…”

“…To our knowledge, the present study represents the largest series of sbrt patients reported with respect to this topic to date; it is also the first to include mlr in the analyses. A previous study of 59 patients showed an association of nlr and plr with survival, and plr was associated with an increased risk of nonlocal failure 11 . The univariate regression analyses in that study demonstrated that os was associated with nlr and plr only when the latter variables were coded categorically; the association became statistically nonsignificant when nlr and plr were tested as continuous variables 11 .…”

“…A previous study of 59 patients showed an association of nlr and plr with survival, and plr was associated with an increased risk of nonlocal failure 11 . The univariate regression analyses in that study demonstrated that os was associated with nlr and plr only when the latter variables were coded categorically; the association became statistically nonsignificant when nlr and plr were tested as continuous variables 11 . Using multivariate analyses, we demonstrated that low nlr and mlr are independently predictive of os and that high ratios are associated with disease-unrelated death.…”

“…Patients with clinical T1-2N0M0 nsclc who had received lung sbrt at our institution from January 2005 to January 2012 and who had cbc results within the 3 months before the start of sbrt were included 5,11 . Clinical and treatment data were abstracted from a prospective database that contains information on patient demographics, treatment, toxicities, patterns of recurrence, and cause of death.…”

Cáncer del tracto digestivo: asociación entre el estado nutricional y la capacidad funcional

“…Incluso los cocientes neutrófilo/linfocito y plaquetas/ linfocitos se han estudiado como predictores de agresividad, como de mal pronóstico, debido a que los neutrófilos son fuente del factor de crecimiento endotelial, el cual participa en la angiogénesis y aumenta la capacidad de diseminación del tumor. Además, la elevación de los marcadores inflamatorios sistémicos se asocia a linfocitopenia y a una respuesta alterada de los linfocitos T hacia el tumor [22][23][24] . Considerando que las funciones de las células del sistema inmunitario están influenciadas por sustancias antioxidantes y prooxidantes, y que las células cancerosas sufren perturbaciones en el balance energético de electrones, determinamos los valores totales de linfocitos de los pacientes como marcador de desnutrición y observamos que más de la mitad presentaban algún grado desnutrición, además de encontrar una clara asociación con la capacidad funcional, situación que no constatamos en otros indicadores bioquímicos como la albúmina o el colesterol.…”