Predictive value of immune‐inflammation indices in metabolic response and outcome after curative radiotherapy in patients with non‐small cell lung cancer

Abstract

Introduction Role of systemic inflammation response in prognosis of several solid tumors has been evaluated in quite a lot of recent reports. Objectives In this study, we aimed to investigate the effect of a novel immune response marker; systemic immune‐inflammation index (SII) on metabolic response to chemoradiotherapy and outcome in patients with non‐small cell lung cancer (NSCLC). Other several inflammatory indices such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) were also evaluated in terms of predictive value. Methods Files of 66 newly diagnosed NSCLC patients who underwent curative radiotherapy were retrospectively analyzed. Factors correlated with overall survival was evaluated via univariate and multivariate survival analysis. Results In 20.05 months of median follow‐up 22 (33.33%) patients were alive. Median overall survival, 3 and 5 years survival for the entire group were 25.49 (95% CI: 19.07‐31.91) months, 54.9% and 20.1%, respectively. Among investigated inflammatory indices, only low PNI (≤45.45), was found significantly correlated with poor response rate (P: .024). None of the prognostic factors and inflammatory indices were found statistically significant in terms of overall survival via univariate and multivariate analysis. Conclusions Immunoinflammatory indices are feasible prognostic indicators for clinical use with easily accessible components. In this study, we demonstrated that pretreatment PNI ≤ 45.45 was statistically significant for predicting poor treatment response. None of the indices were significantly correlated with radiation pneumonitis.

Systemic Immune-Inflammation Index Is a Prognostic Factor for Breast Cancer Patients After Curative Resection

“…Several inflammation and immunity-based indicators, including lymphocyte count, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR), have been used in predicting survival outcomes (8)(9)(10)(11). Systemic immune-inflammation index (SII), calculated by lymphocyte, neutrophil, and platelet counts, reflects the balance of host inflammatory and immune status and is an established prognostic factor in several malignies (12)(13)(14). However, the prognostic value of SII in breast cancer patients remains unclear.…”

Dynamic changes in the systemic immune-inflammation index predict the prognosis of EGFR-mutant lung adenocarcinoma patients receiving brain metastasis radiotherapy

“…In the peripheral blood of patients who develop different types of cancers, the numbers of neutrophils and platelets increase remarkably, and these cells produce inflammatory cytokines and chemokines, which may contribute directly to malignant progression [ 25 – 27 ]. Although lymphocytes in tumors may not always be active due to immune escape or tolerance, increased infiltration is associated with a better prognosis in cancer patients [ 28 ]. Therefore, it is concluded that inflammation plays a crucial role in the development and progression of tumors, and SII may be a reliable prognostic index for the survival of cancer patients.…”

Prognostic impact of immune inflammation biomarkers in predicting survival and radiosensitivity in patients with non‐small‐cell lung cancer treated with chemoradiotherapy

“…Since most of the studies usually lean on surgery and/or chemotherapy as treatment modalities, we focused our attention in the literature on the studies on patients who were subjected to radiotherapy, as our aim is to make a comparison with the results of our study. All series had a retrospective design and included patients with locally advanced NSCLC treated with curative radiotherapy 1,23–28 . The inferences obtained can be listed as follows: First, these indices were often examined individually in published studies.…”

“…There are also studies examining the combinations of two, triple and sometimes four indices with different cut‐off values. Yet, significant results were obtained for one or two indices, whereas some studies failed to show a noteworthy relationship 23,25,26 . Second, some researchers evaluated post treatment values and changes regarding these indices.…”