Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors following stereotactic radiation therapy for early-stage non-small cell lung cancer
Menée à partir de données portant sur 149 patients atteints d'un cancer du poumon non à petites cellules de stade précoce traité par radiothérapie stéréotaxique (durée médiane de suivi : 17 mois), cette étude évalue l'association entre le rapport neutrophiles/lymphocytes ou le rapport plaquettes/lymphocytes avant traitement et la survie des patients
Hypothesis : The hematologic indices of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio are correlated with clinical outcomes after stereotactic radiation.
Methods : We retrospectively evaluated the pre-treatment NLR and PLR in patients treated with stereotactic radiation for early-stage non-small cell lung cancer at our institution. 149 patients treated for non-small cell lung cancer were identified, and 59 had stage I disease with neutrophil, platelet, and lymphocyte levels within a 3 month period prior to treatment. Receiver operating characteristic (ROC) analysis was performed to examine cut-off values for survival and non-local failure followed by Kaplan-Meier analysis for survival.
Results : With a median follow up was 17 months, 28 deaths were observed, and the median overall survival for all patients was 43 months. NLR and PLR cut-off values for further survival analysis were determined based on ROC analysis to be 2.98 and 146. The median overall survival was not reached for patients with low NLR or PLR but the survival was 23 months for patients with high NLR or PLR. There was no correlation between NLR and non-local failure, but on multivariate analysis PLR was found to be associated with freedom from non-local failure. Non-local failure rates were 11% for patients with PLR <250 and 58% for PLR >250 (p<0.001).
Conclusion : The pretreatment NLR and PLR represented significant prognostic indicators of survival in patients treated for early-stage non-small cell lung carcinoma with stereotactic radiation. The PLR may be used as a prognostic indicator for non-local failure following stereotactic radiation for early-stage lung cancer.
Copyright (C) 2014 by the European Lung Cancer Conference and the International Association for the Study of Lung Cancer.
Journal of Thoracic Oncology , résumé, 2013