Post-operative radiation effects on lymphopenia, neutrophil to lymphocyte ratio, and clinical outcomes in palatine tonsil cancers

Lin, Alexander; Rao, Yuan James; Chin, R; Campian, Jian; Mullen, D.; Thotala, Dinesh; Daly, Mackenzie; Oppelt, Peter; Hallahan, Dennis E.; Adkins, Douglas R.; Thorstad, Wade L.

doi:10.1016/j.oraloncology.2018.08.008

Cited by 30 publications

(30 citation statements)

References 37 publications

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“…Indeed, all parameters with significant discrimination capacity were collected after the start of RT, rather than at baseline. In line with our results, a number of recently published studies suggest that post-treatment PBC parameters are associated with outcomes of cancer patients after RT or immunotherapy [29][30][31][32][33][34][35]. Barbetta shows that integrating multiple PBC parameters could predict the survival of patients with adult Tlymphoblastic lymphoma [38].…”

Section: Discussionsupporting

confidence: 90%

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

Chen

Guo

et al. 2019

Preprint

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Background Prediction of response to chemoradiotherapy is critical for the optimal management of oesophageal cancer, yet it is still an unmet clinical need. This study aims to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in oesophageal cancer following chemoradiotherapy.Methods 87 patients with primary oesophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a phase II trial. PBC parameters (haemoglobin, neutrophils, platelets, lymphocytes and monocytes) were collected at 7 time points through the course of radiotherapy. The values of peri-treatment PBC parameters in predicting 3-year cumulative hazard of tumour progression were evaluated.Results Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to patients without. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients divided according to their PBCS (high vs medium vs low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that PBCS high (HR 12.2, 95%CI 2.0-76.3, P = 0.007) and medium (HR 5.8, 95%CI 1.2-27.7, P = 0.028) are independent indicators of locoregional progression.Conclusion Peri-treatment PBCS can predict the long-term hazard of locoregional progression after definitive chemoradiotherapy in patients with oesophageal squamous cell carcinoma.

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Section: Discussionsupporting

confidence: 90%

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

Chen

Guo

et al. 2019

Preprint

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“…Indeed, all parameters with significant discrimination capacity were collected after the start of RT, rather than at baseline. In line with our results, a number of recently published studies suggest that post-treatment PBC parameters are associated with outcomes of cancer patients after RT or immunotherapy [3,9,21,25,27,32,40]. Barbetta A et al show that changes of NLR after CRT are associated with risk of recurrence in patients with oesophageal squamous cell carcinoma [3].…”

Section: Discussionsupporting

confidence: 89%

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

Chen

Guo

et al. 2020

Preprint

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Background: Prediction of response to chemoradiotherapy is critical for the optimal management of oesophageal cancer, yet it is still an unmet clinical need. This study aims to evaluate the predictive potential of peri-treatment peripheral blood cells (PBC) in disease progression hazard in oesophageal cancer following chemoradiotherapy.Methods: 87 patients with primary oesophageal squamous cell carcinoma were subjected to definitive concurrent chemoradiotherapy in a phase II trial. PBC parameters (haemoglobin, neutrophils, platelets, lymphocytes and monocytes) were collected at 7 time points through the course of radiotherapy. The values of peri-treatment PBC parameters in predicting 3-year cumulative hazard of tumour progression were evaluated.Results: Patients with disease progression displayed distinct distribution patterns of peri-treatment PBC compared to patients without. Greater prediction capabilities for risk of locoregional disease progression were found in PBC collected after the start of radiotherapy compared to their pretreatment counterparts, and in individual parameters rather than cell-to-cell ratios. The most predictive PBC parameters were integrated by summation and designated as a PBC score (PBCS), which further augmented their predictive power. Patients divided according to their PBCS (high vs medium vs low) had significantly different 3-year cumulative hazards of locoregional progression (58% vs 29% vs 7%, P = 0.0017). Multivariate analysis confirmed that PBCS high (HR 12.2, 95%CI 2.0-76.3, P = 0.007) and medium (HR 5.8, 95%CI 1.2-27.7, P = 0.028) are independent indicators of locoregional progression.Conclusion: Peri-treatment PBCS can predict the long-term hazard of locoregional progression after definitive chemoradiotherapy in patients with oesophageal squamous cell carcinoma.

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“…All articles were published after 2012 and analyzed OS as the primary endpoint. Analyses included PFS in 15 studies, [10,17–30] DFS in 11 studies, [16,17,31–37] DMFS in 8 studies, [19,23,27,30,38,39] DSS in 1 study, [23] and pathologic CR in 2 studies on preoperative CCRT. [25,40] The median NLR cut-off value was 3.1 (range 1.9–5.0).…”

Section: Resultsmentioning

confidence: 99%

“…ROC curves were used to estimate the optimal NLR cut-off value in 14 studies. [10,22–24,27–29,32,35,39,41–44] Majority included all or locally advanced stages, while 2 studies focused only on early stage cancer. [23,44]…”

Section: Resultsmentioning

confidence: 99%

A meta-analysis of the impact of neutrophil-to-lymphocyte ratio on treatment outcomes after radiotherapy for solid tumors

et al. 2019

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Background: To evaluate the impact of neutrophil-to-lymphocyte ratios (NLR) as a prognostic factor in predicting treatment outcomes after radiotherapy (RT) for solid tumors. Methods: PubMed and Embase databases were used to search for articles published by February 2019 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Hazard ratios (HR) with 95% confidence intervals (CI) were used to evaluate the association between NLR levels and treatment outcomes after RT. The primary endpoint was overall survival (OS) rates. Secondary endpoints included progression-free survival, disease-free survival, and disease-specific survival rates. Results: Thirty-eight datasets with a total of 7065 patients were included in the meta-analysis. Patients with high pretreatment NLR demonstrated significantly worse OS with a pooled HR of 1.90 (95% CI 1.66–2.17, P < .001). In patients receiving RT alone, the pooled HR for OS was 1.71 (95% CI 1.44–2.04, P < .001) with no between-study heterogeneity ( I 2 = 0%, P = .46). Conclusion: Elevated pretreatment NLR is associated with poorer survival in cancer patients undergoing RT. Elevated pretreatment NLR prior to RT initiation may be a useful biomarker to predict treatment outcomes and select a subgroup of patients in need of a more aggressive treatment approach.

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Post-operative radiation effects on lymphopenia, neutrophil to lymphocyte ratio, and clinical outcomes in palatine tonsil cancers

Cited by 30 publications

References 37 publications

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

Peri-treatment peripheral blood cell score predicts long-term locoregional progression hazard in oesophageal squamous cell carcinoma after definitive chemoradiotherapy

A meta-analysis of the impact of neutrophil-to-lymphocyte ratio on treatment outcomes after radiotherapy for solid tumors

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