Pretreatment combination of platelet counts and neutrophil–lymphocyte ratio predicts survival of nasopharyngeal cancer patients receiving intensity-modulated radiotherapy

Abstract

BackgroundIncreased cancer-related inflammation has been associated with unfavorable clinical outcomes. The combination of platelet count and neutrophil–lymphocyte ratio (COP-NLR) has related outcomes in several cancers, except for nasopharyngeal carcinoma (NPC). This study evaluated the prognostic value of COP-NLR in predicting outcome in NPC patients treated with intensity-modulated radiotherapy (IMRT).Materials and methodsWe analyzed the data collected from 232 NPC patients. Pretreatment total platelet counts, neutrophil–lymphocyte ratio (NLR), and COP-NLR score were evaluated as potential predictors. Optimal cutoff values for NLR and platelets were determined using receiver operating curve. Patients with both elevated NLR (>3) and platelet counts (>300×109/L) were assigned a COP-NLR score of 2; those with one elevated or no elevated value were assigned a COP-NLR a score of 1 or 0. Cox proportional hazards model was used to test the association of these factors and relevant 3-year survivals.ResultsPatients (COP-NLR scores 1 and 2=85; score 0=147) were followed up for 55.19 months. Univariate analysis showed no association between pretreatment NLR >2.23 and platelet counts >290.5×109/L and worse outcomes. Multivariate analysis revealed that those with COP-NLR scores of 0 had better 3-year disease-specific survival (P=0.02), overall survival (P=0.024), locoregional relapse-free survival (P=0.004), and distant metastasis-free survival (P=0.046). Further subgrouping by tumor stage also revealed COP-NLR to be an unfavorable prognostic indicator of 3-year failure-free survival (P=0.001) for locally advanced NPC.ConclusionCOP-NLR score, but not NLR alone or total platelet count alone, predicted survival in NPC patients treated with IMRT-based therapy, especially those with stage III/IVA, B malignancies.

Prognostic values of hematological biomarkers in nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy

“…Lu A et al [ 36 ] revealed that NLR ≥ 2.28 indicated poor OS and PFS, with PLR ≥ 174 correlated with inferior OS. Lin et al [ 37 ] believed the combination of platelet with NLR (COP-NLR score) was a better predictor compared with NLR alone or APC alone. A latest meta-analysis by Su et al [ 38 ] evaluated the hematological parameters in NPC patients, and suggested the significant role of NLR and lymphocyte in prognostic prediction.…”

Inflammation Score System using Preoperative Inflammatory Markers to Predict Prognosis for Hepatocellular Carcinoma after Hepatectomy: A Cohort Study

“…Evidently, high pretreatment PLR and NLR promote tumor spread, tumor cell invasion, and adhesion 10 . In addition, many studies have established the prognostication value of a new cancer-related inflammatory system, that is, the combination of inflammation indices on many malignant tumors, such as non-small cell lung cancer, gastric cancer, and nasopharyngeal cancer 11 - 13 . We developed a novel inflammation-based score system to predict survival outcomes using five preoperational inflammatory markers in HCC after surgery.…”

Predictive impact of the inflammation‐based indices in colorectal cancer patients with adjuvant chemotherapy

“…Although the adjuvant chemotherapy of colorectal cancer have greatly improved several decades, survival outcomes still remain a poor prognosis and leads most common cause of cancer-related death. 14 CoNLR-PLR, combined neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio.…”