The prognostic value of pre-treatment thrombocytosis in two cohorts of patients with non-small cell lung cancer treated with curatively intended chemoradiotherapy

Abstract

Chemoradiotherapy is the standard of care for inoperable stage III non-small cell lung cancer (NSCLC). This treatment, however, offers only a small chance of cure and is associated with many side effects. Little research has been made concerning which patients benefit most/least from the treatment. The present study evaluates the prognostic value of anemia, leukocytosis and thrombocytosis at diagnosis in this treatment setting. In the present study, data were collected retrospectively for 222 patients from two different phase II studies conducted between 2002-2007 in Sweden with patients treated with chemoradiotherapy for stage IIIA-IIIB NSCLC. Clinical data and the serum values of hemoglobin (Hgb), White blood cells (WBC) and Platelets (Plt) at enrollment were collected for all patients and studied in relation to overall survival using Kaplan-Meier product-limit estimates and a multivariate Cox proportional hazards regression model. The results showed that patients with thrombocytosis (Plt > 350 x 109/L) had a shorter median overall survival (14.5 months) than patients with normal Plt at baseline (23.7 months). Patients with leukocytosis (WBC > 9 x 109/L) had a shorter median survival (14.9 months) than patients with a normal WBC at baseline (22.5 months). However, in a multivariate model including all lab parameters and clinical factors, only thrombocytosis and performance status displayed a prognostic significance. In Conclusion, thrombocytosis showed to be an independent prognostic marker associated with shorter overall survival in stage III NSCLC treated with curatively intended chemoradiotherapy. This knowledge can potentially be used together with established prognostic factors, such as performance status when choosing the optimal therapy for the individual patient in this clinical setting.

Prognostic value of platelet count and lymphocyte to monocyte ratio combination in stage IV non-small cell lung cancer with malignant pleural effusion

“…Thrombocytosis is associated with worse outcomes in NSCLC [ 19 , 26 , 27 ]. Past studies have shown that platelets have significant roles in tumor activity.…”

“…Moreover, lymphocyte to monocyte ratio (LMR) is an independent prognostic factor in NSCLC [ 18 ]. Thrombocytosis also predicts worse outcomes in lung cancer [ 19 ]. In addition to single inflammatory biomarkers, combinations of single biomarkers with known predictability have also been evaluated for their prognostic values [ 12 , 20 ].…”

Radiation-Induced Lung Injury—Current Perspectives and Management

“…Another large Sweden based retrospective study looked at adverse effects of radiation among patient’s lung cancer and found no difference in the Kaplan Meier curve among patients who developed radiation pneumonitis [ 120 ]. Another study identified roughly 1700 patients who underwent curative radiotherapy and screened for patients who developed fatal radiation pneumonitis.…”

Hemastatic biomarkers as prognostic factors in locoregionally advanced nasopharyngeal carcinoma treated with nimotuzumab plus chemoradiotherapy

“…Fibrin provides a scaffold for tumor cell anchorage and invasion, and protects tumor cells from immune system recognition and destruction [4]. Several studies have confirmed that an increase in platelet number and FIB level were correlated with poor prognosis in many solid tumor types [24][25][26][27][28][29]. A similar conclusion was also drawn in NPC [5][6][30][31][32][33].…”