Nikhil Sebastian1, Trudy Wu1, Jose Bazan1, Erin Driscoll2, Henning Willers2, Nikhil Yegya-Raman3, Laura Bond3, Abhishek Dwivedi3, Xiaokui Mo4, Yubo Tan4, Meng Xu-Welliver1, Karl Haglund1, Salma K Jabbour3, Florence K Keane2, Terence M Williams5. 1. Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, USA. 2. Department of Radiation Oncology, Massachusetts General Hospital, Boston, USA. 3. Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, USA. 4. Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, USA. 5. Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, USA. Electronic address: terence.williams@osumc.edu.
Abstract
BACKGROUND: Neutrophil-lymphocyte ratio (NLR) has been associated with mortality in several disease sites. We hypothesized that NLR is associated with inferior outcomes in localized non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). METHODS: We evaluated the association of pre-treatment NLR, obtained within 6 months of starting SBRT, with overall survival, as well as primary tumor, regional, and distant recurrence. Multivariate Cox regression was then used to assess pre-treatment NLR as a predictor of mortality. We validated our findings in an independent cohort of patients treated at two other institutions. In a secondary analysis, we also evaluated the association of post-treatment NLR with mortality in the training cohort. RESULTS: A total of 156 patients and 166 tumors were included in the training cohort with a median follow-up of 13.4 months. After dichotomization by median, NLR > 3.6 was associated with mortality on univariate (p = 0.010) and multivariate analysis (p = 0.023). In the validation cohort, NLR > 3.6 was similarly associated with mortality on univariate (p = 0.031) and multivariate (p = 0.007) analysis. In a secondary analysis in the training cohort, we found post-treatment NLR was significantly increased compared to pre-treatment NLR (p < 0.001) and associated with mortality on univariate analysis (p = 0.005) and multivariate analysis (p = 0.010). CONCLUSIONS: Pre-treatment NLR > 3.6 is associated with mortality in patients treated with SBRT. This finding was validated in an independent cohort of patients treated at two other institutions. Additionally, post-treatment NLR was significantly increased from pre-treatment and associated with overall survival.
BACKGROUND: Neutrophil-lymphocyte ratio (NLR) has been associated with mortality in several disease sites. We hypothesized that NLR is associated with inferior outcomes in localized non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). METHODS: We evaluated the association of pre-treatment NLR, obtained within 6 months of starting SBRT, with overall survival, as well as primary tumor, regional, and distant recurrence. Multivariate Cox regression was then used to assess pre-treatment NLR as a predictor of mortality. We validated our findings in an independent cohort of patients treated at two other institutions. In a secondary analysis, we also evaluated the association of post-treatment NLR with mortality in the training cohort. RESULTS: A total of 156 patients and 166 tumors were included in the training cohort with a median follow-up of 13.4 months. After dichotomization by median, NLR > 3.6 was associated with mortality on univariate (p = 0.010) and multivariate analysis (p = 0.023). In the validation cohort, NLR > 3.6 was similarly associated with mortality on univariate (p = 0.031) and multivariate (p = 0.007) analysis. In a secondary analysis in the training cohort, we found post-treatment NLR was significantly increased compared to pre-treatment NLR (p < 0.001) and associated with mortality on univariate analysis (p = 0.005) and multivariate analysis (p = 0.010). CONCLUSIONS: Pre-treatment NLR > 3.6 is associated with mortality in patients treated with SBRT. This finding was validated in an independent cohort of patients treated at two other institutions. Additionally, post-treatment NLR was significantly increased from pre-treatment and associated with overall survival.
Authors: Nikhil T Sebastian; Rohit Raj; Rahul Prasad; Christian Barney; Jeremy Brownstein; John Grecula; Karl Haglund; Meng Xu-Welliver; Terence M Williams; Jose G Bazan Journal: Front Oncol Date: 2020-11-05 Impact factor: 6.244
Authors: Nikhil V Kotha; Daniel R Cherry; Alex K Bryant; Vinit Nalawade; Tyler F Stewart; Brent S Rose Journal: Clin Transl Radiat Oncol Date: 2021-04-07
Authors: Ji Young Park; Seung Hun Jang; Chang Youl Lee; Taehee Kim; Soo Jie Chung; Ye Jin Lee; Hwan Il Kim; Joo-Hee Kim; Sunghoon Park; Yong Il Hwang; Ki-Suck Jung Journal: Tuberc Respir Dis (Seoul) Date: 2022-01-20