Neutrophil/Lymphocyte Ratio and Prognosis in Patients with Non-Metastatic Nasopharyngeal Cancer: A Single-Center Experience
Neutrophil/Lymphocyte Ratio and Prognosis in Patients with Non-Metastatic Nasopharyngeal Cancer: A Single-Center Experience
OBJECTIVENasopharyngeal cancer’s presentation and prognosis are variable. Even patients with the same clinical stagecan have very different prognoses. The aim of the present study was to investigate clinical outcomes andprognosis, especially the effects of neutrophil/lymphocyte ratio (NLR), of non-metastatic nasopharyngealcarcinoma (NPC) in patients receiving radiotherapy (RT)±chemotherapy (CT) between March 2006 andAugust 2017 in the Eskişehir Osmangazi University Medical Faculty of Radiation Oncology Department.METHODSSixty-two patients with non-metastatic NPC treated with RT±CT were retrospectively evaluated. Patientcharacteristics, such as age, gender, Karnofsky Performance Status (KPS), T phase, N phase, tumor,lymph node, and metastasis phase, histopathologic subgroup, tumor size, NLR, and hemoglobin value,and treatment characteristics, such as concurrent/adjuvant CT status, RT intermission time, and RTtotal time, were investigated.RESULTSMedian overall survival (OS) was 55 (10–134) months, whereas median disease-free survival was 44(6–129) months. The median duration of local control was 48 (6–129) months. Eleven (17.7%) patients developed distant metastases. Distant metastases were detected in 6 (9.7%) patients who had localcontrol. Statistically significant results were obtained between general survival and sex (p=0.015), KPS(p
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- 1. Chua MLK, Wee JTS, Hui EP, Chan ATC. Nasopharyngeal carcinoma. Lancet 2016;387(10022):1012–24.
- 2. Lee AW, Ma BB, Ng WT, Chan AT. Management of
Nasopharyngeal Carcinoma: Current Practice and Future Perspective. J Clin Oncol 2015;33(29):3356–64.
- 3. Sun R, Qiu HZ, Mai HQ, Zhang Q, Hong MH, Li YX,
et al. Prognostic value and differences of the sixth and
seventh editions of the UICC/AJCC staging systems in
nasopharyngeal carcinoma. J Cancer Res Clin Oncol
2013;139(2):307–14.
- 4. Tang LQ, Chen QY, Fan W, Liu H, Zhang L, Guo L,
et al. Prospective study of tailoring whole-body dualmodality [18F]fluorodeoxyglucose positron emission
tomography/computed tomography with plasma Epstein-Barr virus DNA for detecting distant metastasis
in endemic nasopharyngeal carcinoma at initial staging. J Clin Oncol 2013;31(23):2861–9.
- 5. Chua M, Whee Sze O, Wee J, Soong Y, Lim D, Tan T.
Plasma EBV DNA as a Predictive Biomarker in Patients With Endemic Nasopharyngeal Carcinoma
Treated With Induction Chemotherapy and Concurrent Chemoradiation Therapy. Int J Radiat Oncol Biol
Phys 2014;90(1):S120–S1.
- 6. Leung SF, Chan KC, Ma BB, Hui EP, Mo F, Chow KC,
et al. Plasma Epstein-Barr viral DNA load at midpoint of radiotherapy course predicts outcome in advanced-stage nasopharyngeal carcinoma. Ann Oncol
2014;25(6):1204–8.
- 7. Shen L, Zhang H, Liang L, Li G, Fan M, Wu Y, et al.
Baseline neutrophil-lymphocyte ratio (≥2.8) as a prognostic factor for patients with locally advanced rectal
cancer undergoing neoadjuvant chemoradiation. Radiat Oncol 2014;9:295.
- 8. Zhao QT, Yang Y, Xu S, Zhang XP, Wang HE, Zhang
H, et al. Prognostic role of neutrophil to lymphocyte
ratio in lung cancers: a meta-analysis including 7,054
patients. Onco Targets Ther 2015;8:2731–8.
- 9. Diakos CI, Charles KA, McMillan DC, Clarke SJ.
Cancer-related inflammation and treatment effectiveness. Lancet Oncol 2014;15(11):e493–503.
- 10.McMillan DC. Systemic inflammation, nutritional
status and survival in patients with cancer. Curr Opin
Clin Nutr Metab Care 2009;12(3):223–6.
- 11.Shalapour S, Karin M. Immunity, inflammation, and
cancer: an eternal fight between good and evil. J Clin
Invest 2015;125(9):3347–55.
- 12.Sun W, Zhang L, Luo M, Hu G, Mei Q, Liu D, et al.
Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma: Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Head Neck 2016;38 Suppl 1:E1332–40.
- 13.Liao LJ, Hsu WL, Wang CT, Lo WC, Cheng PW, Shueng
PW, et al. Prognostic impact of pre-treatment neutrophil-to-lymphocyte ratio (NLR) in nasopharyngeal
carcinoma: A retrospective study of 180 Taiwanese patients. Clin Otolaryngol 2018;43(2):463–469.
- 14.Jin Y, Ye X, He C, Zhang B, Zhang Y. Pretreatment
neutrophil-to-lymphocyte ratio as predictor of survival for patients with metastatic
nasopharyngeal carcinoma. Head Neck 2015;37(1):69–75.
- 15.Chen C, Sun P, Dai QS, Weng HW, Li HP, Ye S. The
Glasgow Prognostic Score predicts poor survival in cisplatin-based treated patients with metastatic nasopharyngeal carcinoma. PLoS One 2014;9(11):e112581.
- 16.Lu A, Li H, Zheng Y, Tang M, Li J, Wu H, et al. Prognostic Significance of Neutrophil to Lymphocyte Ratio, Lymphocyte to Monocyte Ratio, and Platelet to
Lymphocyte Ratio in Patients with Nasopharyngeal
Carcinoma. Biomed Res Int 2017;3047802.
- 17.Liew KY, Zulkiflee AB. Neutrophil-lymphocyte ratios
in the prognostication of primary non-metastaticnasopharyngeal carcinoma. Braz J Otorhinolaryngol
2018;84(6):764–71.
- 18.Tecchio C, Scapini P, Pizzolo G, Cassatella MA. On the
cytokines produced by human neutrophils in tumors.
Semin Cancer Biol 2013;23(3):159–70.
- 19.Neagoe PE, Brkovic A, Hajjar F, Sirois MG. Expression and release of angiopoietin-1 from human neutrophils: intracellular mechanisms. Growth Factors
2009;27(6):335–44.
- 20.Tecchio C, Cassatella MA. Neutrophil-derived cytokines involved in physiological and pathological angiogenesis. Chem Immunol Allergy 2014;99:123–37.
- 21.Basso S, Zecca M, Merli P, Gurrado A, Secondino S,
Quartuccio G, et al. T cell therapy for nasopharyngeal
carcinoma. J Cancer 2011;2:341–6.
- 22.Kryczek I, Banerjee M, Cheng P, Vatan L, Szeliga W, Wei
S, et al. Phenotype, distribution, generation, and functional and clinical relevance of Th17 cells in the human
tumor environments. Blood 2009;114(6):1141–9.
- 23.He JR, Shen GP, Ren ZF, Qin H, Cui C, Zhang Y, et
al. Pretreatment levels of peripheral neutrophils and
lymphocytes as independent prognostic factors in
patients with nasopharyngeal carcinoma. Head Neck
2012;34(12):1769–76.
- 24.Ozdemir Y, Akin ML, Sucullu I, Balta AZ, Yucel E.
Pretreatment neutrophil/lymphocyte ratio as a prognostic aid in colorectal cancer. Asian Pac J Cancer Prev
2014;15(6):2647–50.
- 25.Rachidi S, Wallace K, Wrangle JM, Day TA, Alberg AJ,
Li Z. Neutrophil-to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma. Head Neck 2016;38 Suppl 1:E1068–74.
- 26.Zeng Q, Shen LJ, Guo X, Guo XM, Qian CN, Wu PH.
Critical weight loss predicts poor prognosis in nasopharyngeal carcinoma. BMC Cancer 2016;16:169.
- 27.Turen S, Ozyar E, Altundag K, Gullu I, Atahan IL.
Serum lactate dehydrogenase level is a prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
Cancer Invest 2007;25(5):315–21.