Neutrophil‐lymphocyte ratio and a dosimetric factor for predicting symptomatic radiation pneumonitis in non‐small‐cell lung cancer patients treated with concurrent chemoradiotherapy

Lee, Yun Hee; Choi, Hyejung; Jeong, Hojin; Kang, Ki Mun; Song, Jin Ho; Lee, Won Sup; Lee, Gyeong‐Won; Song, Haa‐Na; Kim, Hoon-Gu; Kang, Myoung Hee; Rhee, Dong Yoon; Jeong, Bae Kwon

doi:10.1111/crj.12660

Cited by 21 publications

(16 citation statements)

References 27 publications

(57 reference statements)

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“…There are very few studies evaluating their role in stage I NSCLC undergoing SBRT [15], [16]. Most of these studies have limited their blood values measured within the 3 month period prior to initiating therapy [9], [10], [11], [12], [13], [15], [17]. Moreover, none of the studies have evaluated the changes in the values of the hematological parameters between pre-SBRT and post-SBRT.…”

Section: Introductionmentioning

confidence: 99%

Anemia is a poor prognostic factor for stage I non-small cell lung cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT)

Pathak

Pantarotto

Cook

et al. 2019

Clinical and Translational Radiation Oncology

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HighlightsThis study reports on the prognostic ability of haematological parameters for the largest known biopsy-proven stage-I medically inoperable cohort treated with SBRT.After SBRT, the median values of Hb, ALC, ANC and TPC declined whereas the NLR and the PLR increased as compared to pre-SBRT.Anemia along with other parameters was found to be a poor prognostic factor for local control despite treatment with SBRT to doses of >100 Gy BED10.Simple and minimally invasive methods like a peripheral blood sample can provide prognostic information even for stage-I NSCLC patients.Patient, tumor and treatment factors along with molecular markers should be used to create risk stratification models that can guide therapy.

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Section: Introductionmentioning

confidence: 99%

Anemia is a poor prognostic factor for stage I non-small cell lung cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT)

Pathak

Pantarotto

Cook

et al. 2019

Clinical and Translational Radiation Oncology

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“… 22 , 23 Current studies have shown that NLR can predict the occurrence of radiation pneumonia in patients with tumor radiotherapy. 17 , 18 Lee et al pointed out that NLR combined with dosimetric factors could predict symptomatic radiation pneumonitis in patients with NSCLC who received concurrent radiotherapy and chemotherapy. 17 Pan et al found that combining NLR, V20, and mean lung dose could predict radiation-induced lung injury in lung cancer patients receiving concurrent IMRT and chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“… 17 , 18 Lee et al pointed out that NLR combined with dosimetric factors could predict symptomatic radiation pneumonitis in patients with NSCLC who received concurrent radiotherapy and chemotherapy. 17 Pan et al found that combining NLR, V20, and mean lung dose could predict radiation-induced lung injury in lung cancer patients receiving concurrent IMRT and chemotherapy. 18 Multivariate analysis showed that total dose ≥60 Gy, V20 ≥20%, mean lung dose ≥12 Gy, and NLR ≥2.2 were still independent predictors of RP ( P =0.010, 0.043, 0.028, and 0.015, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Lee et al conducted a retrospective analysis of patients with stage III non-small cell lung cancer receiving concurrent chemoradiation and found that patients with symptomatic radiation pneumonitis had higher NLR and C-reactive protein levels ( P =0.067 and P =0.012, respectively). 17 The NLR was statistically significant for progression of radiation pneumonia to symptomatic pneumonia. Pan et al found that combining NLR, V20, and mean lung dose could predict radiation-induced lung injury in lung cancer patients receiving concurrent IMRT and chemotherapy.…”

Section: Introductionmentioning

confidence: 92%

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<p>The Predictive Value of MLR for Radiation Pneumonia During Radiotherapy of Thoracic Tumor Patients</p>

Gao¹,

Wu²,

Li³

et al. 2020

CMAR

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Purpose: To evaluate the predictive value of blood lymphocyte, monocyte to lymphocyte ratio (MLR), and neutrophil to lymphocyte ratio (NLR) for radiation pneumonia (RP) in patients with thoracic tumors receiving radiotherapy. Patients and Methods: The clinical data of 65 patients with thoracic tumor (esophageal cancer, lung cancer) treated by radiotherapy in our hospital were retrospectively analyzed. Patients were divided into the RP group and the non-RP group according to the Common Terminology Criteria for Adverse Events (CTCAE 5.0). Data on blood cell counts, including lymphocytes, monocytes, and neutrophils, were collected before (0 weeks) and after 1, 2, and 4 weeks of radiotherapy. Results: Of the 65 patients enrolled, 27 developed radiation pneumonia and 38 did not. Patients' clinical factors, including age, TNM stage, tumor type, underlying lung disease, and history of smoking, had no correlation with RP. ANOVA of repeated measurement data showed that the changes of MLR in the group with RP during radiotherapy were significantly different from those in the non-RP group (P<0.05). The RP prediction model based on the identified risk factors was established using receiver operator characteristic curves. The results showed that the area under the curve for the monocyte to lymphocyte ratio was 0.755 (95% CI, 0.63-0.87, P=0.000), and the best cutoff point for MLR was 0.426. Conclusion: MLR could predict radiation pneumonia in patients with thoracic tumor radiotherapy and achieve early monitoring, early prevention, and treatment.

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“…However, despite being treated according to the dose constraint guidelines for radiation treatment planning, patients still experience Gr ≥ 2 RP. It is believed that the underlying mechanism associated with the patient's robust immune reaction may be associated with this [4].…”

Section: Introductionmentioning

confidence: 99%

Cytokine Profiles of Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy with Regards to Radiation Pneumonitis Severity

Jeong

Kim

Jung

et al. 2021

JCM

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The immunologic aspects of radiation pneumonitis (RP) are unclear. We analyzed variations in cytokine profiles between patients with grade (Gr) 0–1 and Gr ≥ 2 RP. Fifteen patients undergoing concurrent chemoradiotherapy for non-small cell lung cancer were included. Blood samples of 9 patients with Gr 0–1 and 6 with Gr ≥ 2 RP were obtained from the Biobank. Cytokine levels were evaluated using an enzyme linked immunosorbent assay at before radiotherapy (RT) initiation, 1, 3, and 6 weeks post-RT initiation, and 1 month post-RT completion. Concentrations of granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-6, IL-10, IL-13, IL-17, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β were analyzed; none were related to the occurrence of Gr ≥ 2 RP at pre-RT initiation. At 3 weeks, relative changes in the G-CSF, IL-6, and IFN-γ levels differed significantly between the groups (p = 0.026, 0.05 and 0.026, respectively). One month post-RT completion, relative changes of IL-17 showed significant differences (p = 0.045); however, relative changes in TNF-α, IL-10, IL-13, and TGF-β, did not differ significantly. Evaluation of changes in IL-6, G-CSF, and IFN-γ at 3 weeks after RT initiation can identify patients pre-disposed to severe RP. The mechanism of variation in cytokine levels in relation to RP severity warrants further investigation.

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Neutrophil‐lymphocyte ratio and a dosimetric factor for predicting symptomatic radiation pneumonitis in non‐small‐cell lung cancer patients treated with concurrent chemoradiotherapy

Abstract: The NLR at radiological RP is a useful biomarker for predicting symptomatic RP development after CCRT in stage III NSCLC patients.

Cited by 21 publications

References 27 publications

Anemia is a poor prognostic factor for stage I non-small cell lung cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT)

Anemia is a poor prognostic factor for stage I non-small cell lung cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT)

<p>The Predictive Value of MLR for Radiation Pneumonia During Radiotherapy of Thoracic Tumor Patients</p>

Cytokine Profiles of Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy with Regards to Radiation Pneumonitis Severity

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