Prognostic utility of pretreatment neutrophil-lymphocyte ratio in survival outcomes in localized non-small cell lung cancer patients treated with stereotactic body radiotherapy: Selection of an ideal clinical cutoff point
| العنوان: | Prognostic utility of pretreatment neutrophil-lymphocyte ratio in survival outcomes in localized non-small cell lung cancer patients treated with stereotactic body radiotherapy: Selection of an ideal clinical cutoff point |
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| المؤلفون: | Alex K. Bryant, Nikhil V. Kotha, Daniel R Cherry, Brent S. Rose, Vinit Nalawade, Tyler F. Stewart |
| المصدر: | Clinical and Translational Radiation Oncology, Vol 28, Iss, Pp 133-140 (2021) Clinical and Translational Radiation Oncology |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Oncology, Veterans affairs, Stereotactic body radiotherapy, Lymphocyte, R895-920, NSCLC, 030218 nuclear medicine & medical imaging, Pulmonary function testing, Medical physics. Medical radiology. Nuclear medicine, 0302 clinical medicine, Non-small cell lung cancer, Medicine, Cutoff, NLR, Neutrophil-lymphocyte ratio, Lung, RC254-282, Cancer, LCS, lung cancer-specific survival, education.field_of_study, non-lung cancer survival, SBRT, Lung Cancer, OS, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, respiratory system, NCS, medicine.anatomical_structure, 030220 oncology & carcinogenesis, VA, Veterans Affairs, LCS, Subset Analysis, medicine.medical_specialty, overall survival, Population, Prognostic factors, NCS, non-lung cancer survival, Article, NLR, OS, overall survival, 03 medical and health sciences, SBRT, stereotactic body radiotherapy, Clinical Research, NSCLC, non-small cell lung cancer, Internal medicine, Radiology, Nuclear Medicine and imaging, education, Lung cancer, Veterans Affairs, Neutrophil-lymphocyte ratio, business.industry, fungi, Veterans affairs (U.S.), medicine.disease, respiratory tract diseases, VA, Good Health and Well Being, lung cancer-specific survival, business |
| الوصف: | Highlights • Neutrophil-lymphocyte ratio is a promising prognostic marker for several cancers. • NLR is not useful as a marker of lung cancer survival in localized lung cancer. • NLR has potential as a marker of competing mortality risk in localized lung cancer. • NLR cutoff of 4.0 is proposed as a clinically useful cutoff point. Background and purpose Neutrophil-lymphocyte ratio (NLR) has been associated with overall survival (OS) in non-small cell lung cancer (NSCLC). We aimed to assess the utility of NLR as a predictor of lung cancer-specific survival (LCS) and identify an optimal, pretreatment cutoff point in patients with localized NSCLC treated with stereotactic body radiotherapy (SBRT) within the Veterans Affairs’ (VA) national database. Materials and methods In the VA database, we identified patients with biopsy-proven, clinical stage I NSCLC treated with SBRT between 2006 and 2015. Cutoff points for NLR were calculated using Contal/O’Quigley’s and Cox Wald methods. Primary outcomes of OS, LCS, and non-lung cancer survival (NCS) were evaluated in Cox and Fine-Gray models. Results In 389 patients, optimal NLR cutoff was identified as 4.0. In multivariable models, NLR > 4.0 was associated with decreased OS (HR 1.44, p = 0.01) and NCS (HR 1.68, p = 0.01) but not with LCS (HR 1.32, p = 0.09). In a subset analysis of 229 patients with pulmonary function tests, NLR > 4.0 remained associated with worse OS (HR 1.51, p = 0.02) and NCS (HR 2.18, p = 0.01) while the association with LCS decreased further (HR 1.22, p = 0.39). Conclusion NLR was associated with worse OS in patients with localized NSCLC treated with SBRT; however, NLR was only associated with NCS and not with LCS. Pretreatment NLR, with a cutoff of 4.0, offers potential as a marker of competing mortality risk which can aid in risk stratification in this typically frail and comorbid population. Further studies are needed to validate pretreatment NLR as a clinical tool in this setting. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2405-6308 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3b10c14c1195351a0dd0c4911b94a9b9 http://www.sciencedirect.com/science/article/pii/S2405630821000343 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3b10c14c1195351a0dd0c4911b94a9b9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 24056308 |
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