THE ROLE OF NEUTROPHIL TO LYMPHOCYTE RATIO IN TOXICITY AND RESPONSE OF HEAD AND NECK CANCER PATIENTS TREATED WITH CONCURRENT CHEMORADIATION

Abstract

Background- Neutrophil to Lymphocyte Ratio (NLR) is a haematogical marker which signies inammatory burden and treatment outcome of a malignancy. We investigated prognostic value of NLR in Head and Neck Squamous Cell Carcinoma (HNSCC) patients treated with concurrent chemoradiotherapy. To compare acute toxicity, locoregional control, disease burden w Aims & Objective- ith patients with high (>4) and low (≤4) NLR groups. Head and neck squamous cell carcinoma patients treated with concurre Materials And Methods- nt chemoradiotherapy were retrospectively selected from the records of Department of Radiation Oncology, Medical College Kolkata between 2018-2021. Baseline Neutrophil to Lymphocyte Ratio (NLR) was calculated using Differential Leucocyte Count (DLC) of Complete Blood Count (CBC) measured 10 days before the treatment initiation. An NLR value of greater than 4 has been considered as high. Data regarding stage at presentation, acute oral mucositis, acute dysphagia, anaemia, clinicoradiological response to treatment at 6 weeks after completion of chemoradiation were taken. ResultsWe analysed 150 patients between 2018-2021. Primary sites were oral cavity (37.3%), oropharynx (24%), hypopharynx (10.7%), larynx (28%). Our data suggests high baseline NLR correlates with poor prognosis because of more disease burden and poor treatment response. More numbers of locally advanced disease (T3 & T4) belong to high NLR group (P value= <0.0001). Grade II or more acute toxicities i.e oral mucositis, dysphagia was observed in high NLR group (P value <0.0001), which were statistically signicant. Complete radiological response is lower in high NLR group, which was statistically signicant (P Value = <0.0001). Mean Local Recurrence Free Survival (In Months) was less in high NLR group, this was also statistically signicant. This study suggests that in head and neck squamous c Conclusion- ell carcinoma, high NLR is correlated with higher stage of presentation, more acute locoregional toxicity during chemoradiotherapy, poor response to therapy and low local recurrence free survival (In Months)