The Derived Neutrophil/Lymphocyte Ratio Predicts Poor Clinical Outcome in Early Stage Non-Small Cell Lung Patients Who Received Stereotactic Body Radiation Therapy

Abstract

Inflammation plays a critical role in carcinogenesis and tumor proliferation. The derived neutrophil-lymphocyte ration (dNLR) is a systemic inflammatory marker. The aim of this study was to evaluate pre-treatment dNLR as prognostic factor in early stage non-small cell lung cancer (NSCLC). Patients with newly diagnosed NSCLC who were eligible for stereotactic body radiotherapy (SBRT) treatment were enrolled from 2011 to 2015 in the study. Pre-treatment dNLR was calculated from peripheral blood count before SBRT. Receiver operating curve (ROC) was applied to determine the optimal cut-off values of dNLR. The impact of pre-treatment dNLR on disease free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and Cox proportional models. In the 64 patients eligible for analysis, median follow up period was 30 months. An optimal cut off value of 2.0 for the dNLR was determined by ROC curves. Kaplan-Meier curves demonstrated that an elevated dNLR was correlated with decreased DFS and OS. In univariate analysis, low dNLR was associated with improved survival; moreover, multivariate analysis revealed that an increased dNLR was an independent significant poor prognostic factor for both DFS and OS. Pre-treatment dNLR is easily obtained and could be considered as a useful prognostic biomarker in patients with early stage NSCLC that are eligible for SBRT.