The association between neutrophil-to-lymphocyte ratio and treatment response in nasopharyngeal cancer patients of Cipto Mangunkusumo General Hospital in 2015-2018: A retrospective cohort study.

123 Background: Nasopharyngeal Cancer (NPC) is the most common head and neck cancer in Indonesia and mostly diagnosed at advanced stage. The patients with same stage of the disease have shown variety of responses against first line chemotherapy, suggesting other factors that could play a role in determining the treatment outcome. Meanwhile, neutrophil-to-lymphocyte ratio (NLR) has been studied to be a prognostic factor in many malignancies. Objective: This study aimed to determine the association between NLR and treatment response in advanced-stage NPC patients of Cipto Mangunkusumo General Hospital (RSCM) in 2015-2018. Methods: We evaluated the medical record of 45 advanced-stage NPC patients that visited RSCM in 2015-2018 retrospectively. The NLR was calculated using the neutrophil and lymphocyte count prior the first chemotherapy. We categorized NLR ≥ 4 as high. We categorized the treatment response by response (CR and PR) and non-response (SD and PD). Results: There were 45 patients included in this study. Demographic profile of the patients were dominated by male (80,0%) with mean age 45.58 (±14.5) years old. The mean of NLR was 7.396 (±5.182). We found 32 (71.1%) patients had high NLR (cut off > 4). Majority of patients with high NLR (71.9%) did not respond to first line treatment. The association between NLR and treatment response was statistically significant ( p = 0.048). Conclusions: We found that high NLR values are associated with poor treatment response in NPC patients. Keywords: Nasopharyngeal cancer, neutrophil-to-lymphocyte ratio, treatment response.