Premium
Neutrophil‐to‐lymphocyte ratio in head and neck cancer
Author(s) -
Haddad Carol R,
Guo Linxin,
Clarke Stephen,
Guminski Alex,
Back Michael,
Eade Thomas
Publication year - 2015
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12305
Subject(s) - medicine , univariate analysis , chemoradiotherapy , cohort , head and neck cancer , cancer , progression free survival , oncology , mucositis , neutrophil to lymphocyte ratio , clinical endpoint , radiation therapy , gastroenterology , multivariate analysis , lymphocyte , overall survival , clinical trial
The neutrophil‐to‐lymphocyte ratio ( NLR ) is an index of systemic inflammatory burden in malignancy. An elevated NLR has been associated with poor prognosis in a number of cancer sites. We investigated its role in a cohort of patients with locally advanced head and neck cancer. Methods Eligible patients had primary mucosal squamous cell carcinoma treated with chemoradiotherapy and a minimum follow‐up of 12 months (unless deceased). NLR was analysed as <5 vs. ≥5 and above and below the median. The primary endpoint was overall survival ( OS ) and secondary endpoints metastasis free survival and locoregional relapse free survival. Actuarial K aplan– M eier statistics and log rank test were used. Univariate analysis for age (continuous), E astern C ooperative O ncology G roup performance status (0 vs. 1), gender (male vs. female), smoking (yes vs. no), A merican J oint C ommittee on C ancer stage ( III vs. IV ) and NLR (<5 vs. ≥5 and <3.3 vs. ≥3.3) were performed. Results Forty‐six patients were included in this analysis. Median NLR was 3.3 (0.4–22.8). After a median follow‐up of 34 months (13–47 months), the 2‐year estimated OS, metastasis free survival and locoregional relapse free survival for NLR <5 vs. ≥5 were 89% vs. 61% (p = 0.017), 84% vs. 64% (p = 0.083) and 81% vs. 70% (p = 0.17) respectively. On univariate analysis NLR ≥5 (p = 0.025), older age (p = 0.01) and ECOG 1 (p = 0.025) were significant for OS . Conclusion In this cohort of locally advanced head and neck cancer patients treated with chemoradiotherapy, pre‐treatment NLR ≥5 was prognostic for mortality. Further studies are required to confirm these results and to assess the interaction with other prognostic factors.