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. 2023 Oct 9;18(10):e0292591.
doi: 10.1371/journal.pone.0292591. eCollection 2023.

Longitudinal measurements of neutrophil-to-lymphocyte ratio in nasopharyngeal cancer treated with concurrent chemoradiotherapy

Pooriwat Muangwong  1   2 , Nontiya Homkham  3 , Wattanapong Narueban  1 , Chin Tadadoltip  1 , Chayaporn Jongjumnien  1 , Nuttida Taenawakun  1 , Jutamas Teerapattanaphong  1 , Imjai Chitapanarux  1   2
Affiliations

Longitudinal measurements of neutrophil-to-lymphocyte ratio in nasopharyngeal cancer treated with concurrent chemoradiotherapy

Pooriwat Muangwong et al. PLoS One. .

Abstract

Objective: We study factors affecting neutrophil-to-lymphocyte ratio (NLR) and its changes throughout the treatment (ΔNLR) of nasopharyngeal carcinoma (NPC) underwent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy (AC) and oncological outcomes including overall survival (OS) and disease-free survival (DFS).

Methods: Data from 81 NPC patients was retrospectively evaluated. NLRs were obtained from first week of CCRT (pre-CCRT), last week of CCRT (end-CCRT), and at last cycle of AC (end-AC). Pre-CCRT NLR was categorized into "low" and "high". End-CCRT and end-AC ΔNLRs were divided into "increased" and "decreased" based on NLR at these two timepoints relative to the value at pre-CCRT. Associations between sex, age, cancer stage and NLR, ΔNLRs were investigated. OS and DFS were reported.

Results: Median NLR at pre-CCRT (2.47) was lower than NLR at end-CCRT (6.29) and end-AC (3.77) (P-value = 0.043). Advanced cancer stage associated with high pre-CCRT NLR (P-value = 0.047). Male gender was associated with "increased" end-CCRT ΔNLR, whereas male gender and age ≤51 were associated with "increased" end-AC ΔNLR. Three-year OS and DFS rates were 85.25% and 76.39%, respectively. There were no statistically significant differences observed in OS and DFS among groups categorized by pre-CCRT NLR, ΔNLRs, gender, age, and cancer stage.

Conclusions: NLR increases during NPC treatment. Advanced staging is associated with higher baseline NLR. Increased ΔNLR is associated with male gender at end-CCRT and male gender with age ≤51 years at end-AC. No relation between NLR and its dynamic change with either OS or DFS was demonstrated.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
Three-year overall survival according to patient characteristics (a) sex, (b) age at pre-CCRT and (c) cancer stage at pre-CCRT. CCRT, concurrent chemoradiotherapy.
Fig 2
Fig 2. Three-year overall survival in subgroup with NLR and ALC at pre-CCRT and NLR and ALC change.
(a) High and low NLR at pre-CCRT, (b) end-CCRT ΔNLR, and (d) end-AC ΔNLR. NLR, neutrophil to lymphocyte ratio; CCRT, concurrent chemoradiotherapy; AC, adjuvant chemotherapy.
Fig 3
Fig 3
Three-year disease-free survival according to patient characteristics (a) sex, (b) age at pre-CCRT and (c) cancer stage at pre-CCRT. CCRT, concurrent chemoradiotherapy.
Fig 4
Fig 4. Three-year disease-free survival in subgroup with NLR and ALC at pre-CCRT and NLR and ALC change.
(a) High and low NLR at pre-CCRT, (b) end-CCRT ΔNLR, and (d) end-AC ΔNLR. NLR, neutrophil to lymphocyte ratio; CCRT, concurrent chemoradiotherapy; AC, adjuvant chemotherapy.
See this image and copyright information in PMC

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