Meiying Guo1, Wanlong Li2, Butuo Li3, Bing Zou2, Shijiang Wang2, Xue Meng2, Xindong Sun2, Jinming Yu4, Linlin Wang5. 1. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Jinan 250117, China. 2. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Jinan 250117, China; Shandong Academy of Medical Sciences, Jinan 250001, China. 3. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Jinan 250117, China; Department of Radiation Oncology and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300270, China. 4. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Jinan 250117, China; Shandong Academy of Medical Sciences, Jinan 250001, China. Electronic address: sdyujinming@163.com. 5. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Jinan 250117, China; Shandong Academy of Medical Sciences, Jinan 250001, China. Electronic address: wanglinlinatjn@163.com.
Abstract
OBJECTIVE: Inflammation plays critical roles in tumor growth and progression, and can be adversely affected by chemotherapy and radiotherapy. However, there have been few studies on the prognostic value of delta (Δ) inflammatory biomarkers before and after chemoradiotherapy in patients with locally advanced non-small cell lung cancer (LA-NSCLC). METHODS: In this study, pre/post-treatment and Δ inflammatory biomarkers of 370 patients who were diagnosed as having inoperable LA-NSCLC in Shandong Cancer Hospital between January 2005 and January 2016 were analyzed. Nomograms were then established for predicting prognosis. RESULTS: Median overall survival (OS) and progression free survival (PFS) for all patients were 28.1 (range 1.9-129.0) months and 11.1 (range 1.7-58.7) months, respectively. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) significantly increased and the lymphocyte-to-monocyte ratio (LMR) significantly decreased during the concurrent chemoradiotherapy course (P < 0.001, P < 0.001, and P < 0.001, respectively). Multivariate analysis revealed that pre-LMR, ΔNLR, and minimum absolute lymphocyte counts were independent predictors of OS (P = 0.027, P = 0.012, and P = 0.015, respectively) and post-LMR, post-NLR, and ΔNLR were independent predictors of PFS (P = 0.014, P = 0.001, and P = 0.036, respectively). Nomograms for OS and PFS were established by combining all significant inflammatory markers and clinicopathological characteristics. The concordance indexes for OS and PFS were 0.709 and 0.688, respectively. CONCLUSION: Post-treatment and Δ inflammatory biomarkers may have more prognostic significance than baseline measurements of inflammatory biomarkers in LA-NSCLC patients. The proposed nomograms based on the dynamic inflammatory biomarkers and clinicopathological factors may be practical and widely available for evaluating the prognosis of patients with inoperable LA-NSCLC.
OBJECTIVE:Inflammation plays critical roles in tumor growth and progression, and can be adversely affected by chemotherapy and radiotherapy. However, there have been few studies on the prognostic value of delta (Δ) inflammatory biomarkers before and after chemoradiotherapy in patients with locally advanced non-small cell lung cancer (LA-NSCLC). METHODS: In this study, pre/post-treatment and Δ inflammatory biomarkers of 370 patients who were diagnosed as having inoperable LA-NSCLC in Shandong Cancer Hospital between January 2005 and January 2016 were analyzed. Nomograms were then established for predicting prognosis. RESULTS: Median overall survival (OS) and progression free survival (PFS) for all patients were 28.1 (range 1.9-129.0) months and 11.1 (range 1.7-58.7) months, respectively. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) significantly increased and the lymphocyte-to-monocyte ratio (LMR) significantly decreased during the concurrent chemoradiotherapy course (P < 0.001, P < 0.001, and P < 0.001, respectively). Multivariate analysis revealed that pre-LMR, ΔNLR, and minimum absolute lymphocyte counts were independent predictors of OS (P = 0.027, P = 0.012, and P = 0.015, respectively) and post-LMR, post-NLR, and ΔNLR were independent predictors of PFS (P = 0.014, P = 0.001, and P = 0.036, respectively). Nomograms for OS and PFS were established by combining all significant inflammatory markers and clinicopathological characteristics. The concordance indexes for OS and PFS were 0.709 and 0.688, respectively. CONCLUSION: Post-treatment and Δ inflammatory biomarkers may have more prognostic significance than baseline measurements of inflammatory biomarkers in LA-NSCLCpatients. The proposed nomograms based on the dynamic inflammatory biomarkers and clinicopathological factors may be practical and widely available for evaluating the prognosis of patients with inoperable LA-NSCLC.
Authors: Giorgio Carlo Ginesu; Panagiotis Paliogiannis; Claudio F Feo; Maria Laura Cossu; Antonio Mario Scanu; Alessandro Fancellu; Alessandro Giuseppe Fois; Angelo Zinellu; Teresa Perra; Simone Veneroni; Alberto Porcu Journal: Curr Oncol Date: 2022-05-08 Impact factor: 3.109