The correlation of response to induction chemotherapy with neutrophil lymphocyte ratio and platelet lymphocyte ratio in oral cavity malignancy

Abstract

Induction chemotherapy yields significant response in locally advanced squamous cell carcinoma of oral cavity. Pre-treatment biomarkers can help to predict response to chemotherapy. The neutrophil-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) are cost-effective and simple parameters that can predict response to chemotherapy. This study aims to find the correlation between NLR, PLR and response to induction chemotherapy in oral cavity malignancies. Materials and Methods: Details of 32 patients with locally advanced squamous cell carcinoma of oral cavity who received induction chemotherapy from Jan 2017-March 2019 were collected and the following were recorded. Pre-treatment total leukocyte count, neutrophil, lymphocyte and platelet counts. Post induction chemotherapy, reduction in size of tumour. Patients were categorised into complete, partial and non-responders.The mean NLR and PLR, and the significance in variation of NLR and PLR between the three groups was calculated and the statistical significance analysed. Results: The mean NLR is significantly low in both partial (2.62) and complete response groups (2.4) compared to the patients with static response (5.6). The mean PLR is also low in responders (124) when compared to the static group (180), but it is not statistically significant. With a cut-off value of 3.95 for NLR and 153 for PLR, response could be predicted with high positive predictive value. When both the ratios are combined the predictive value is further increased as shown in this study. Conclusion: Pre-treatment NLR and PLR are reliable biomarkers of the systemic immunologic phenotype of the cancer patients. They predict the response to chemotherapy in patients with oral cavity malignancy.