Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (6): 36-41.doi: 10.6040/j.issn.1673-3770.0.2020.053

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Changes in and prognostic value of the inflammatory index before and after concurrent chemoradiotherapy for nasopharyngeal carcinoma

FAN Li, LI Yue, XU Ximing   

  1. Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430000, Hubei, China
  • Published:2021-01-11

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Abstract: Objective To investigate the effect of the neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)in peripheral blood on the prognosis of nasopharyngeal carcinoma(NPC)before and after concurrent chemoradiotherapy. Methods Pre-/post-treatment and changes in neutrophil, platelet, and lymphocyte levels of 229 patients who were diagnosed with locally advanced NPC and received concurrent chemoradiotherapy in Renmin Hospital of Wuhan University were retrospectively analyzed. A receiver operating characteristic(ROC)analysis was performed to determine the optimal cutoff values of NLR, PLR, ΔNLR, and ΔPLR, and the patients were then divided into lower and higher groups according to the optimal cutoff values of ΔNLR and ΔPLR. A Kaplan-Meier analysis and Cox risk model were used to identify independent predictors of recurrence and prognosis. Results The areas under the ROC curve of PLR, NLR, ΔNLR, and ΔPLR in the diagnosis of tumor recurrence were 0.680, 0.678, 0.854, and 0.730, respectively, and the optimal cut-off values for each parameter were 2.730, 135.550, 4.982, and 122.553, respectively. Univariate analysis showed that TNM stages, clinical stages, PLR and NLR, ΔNLR, and ΔPLR were correlated with the recurrence of NPC, whereas the Cox regression model suggested that TNM stages, ΔNLR, and ΔPLR were independent risk factors for the recurrence of NPC. Kaplan-Meier analysis found that the 2-year recurrence-free survival rates of the ΔHNLR and ΔHPLR groups were lower than those of the ΔLNLR and ΔLPLR groups(ΔHNLR vs. ΔLNLR=0.488 vs. 0.993; ΔHPLR vs. ΔLPLR=0.476 vs. 0.935), and that the median recurrence-free survival time for both the ΔHNLR and ΔHPLR groups was 23 months. Conclusion Both NLR and PLR in patients with locally advanced NPC increased after concurrent chemoradiotherapy, and poorer prognosis was correlated with higher ΔNLR and ΔPLR values. Therefore, ΔNLR and ΔPLR can be used to assess risk for tumor recurrence in patients with locally advanced NPC.

Key words: Nasopharyngeal carcinoma, Concurrent chemoradiotherapy, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio, Recurrence

CLC Number: 

  • R739.6
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