Neutrophil-To-Lymphocyte Ratio Predicted Long-Term Chemotherapy Benefits In Stage IIIB-IV Non-Squamous Non-Small Cell Lung Cancer Patients Without Sensitive Mutations.

PURPOSE: To investigate the predictive capability of clinical parameters for long-term chemotherapy benefits among stage IIIB-IV non-squamous non-small cell lung cancer (NSCLC) patients without sensitive mutations. PATIENTS AND METHODS: We investigated the clinical features of 206 stage IIIB-IV non-squamous NSCLC patients without sensitive mutations and assessed their predictive value for disease control rate (DCR) at 6 and 12 months post-treatment. RESULTS: Seventy-two patients received docetaxel and platinum-based chemotherapy while 134 received pemetrexed and platinum-based chemotherapy. The 6-month and 12-month DCR were 33 (45.8%) and 6 (8.3%) in the docetaxel group and 69 (51.5%) and 19 (14.2%) in the pemetrexed group, respectively. Univariate Cox regression revealed that age, sex, smoking history, adrenal gland metastasis, stage IV disease, neutrophil-to-lymphocyte ratio (NLR), and serum albumin were associated with unfavorable progression-free survival (PFS). Age, stage IV disease, and NLR were identified as independent predictors of PFS using multivariate analysis. NLR was the only parameter that could predict 3-month and 6-month DCRs. NLR and age were able to predict 12-month DCR, with NLR presenting a larger area under the curve. Kaplan-Meier curves demonstrated that patients with NLR > 2.231 displayed significantly reduced long-term disease control. The group with higher NLR had more male patients, lower ALB levels, and serum sodium levels as well as higher platelet counts. CONCLUSION: NLR was an independent predictor of long-term chemotherapy benefits among non-squamous NSCLC patients without sensitive mutations. Patients with lower NLR were optimal candidates for chemotherapy. Patients with high NLR may receive alternative treatments or be included in clinical trials.

Cochlea sparing with a stratified scheme of dose limitation employed in intensity-modulated radiotherapy for nasopharyngeal carcinoma: A dosimetry study.

Hearing loss is 1 of the major complications after radiotherapy in nasopharyngeal carcinoma (NPC) patients, how to minimize dose to cochlea in order to reduce the incidence of sensorineural hearing loss is a critical task. This study is to investigate a stratified scheme of cochlea sparing based on T stage in intensity-modulated radiotherapy. We designed a comparison between 2 plans of cochlea sparing plan (C-Plan) and regular noncochlea sparing plan (R-Plan) from 19 NPC patients with 2, 3, 8, and 6 cases of T1, T2, T3, and T4 stage, respectively. The outcomes showed that target coverage parameters and dose-volume histogram features were of no significant difference, with a significant difference in dose distribution between C-Plan and R-Plan in cochlea and eustachian, e.g., ipsilateral cochlea Dmean 4619.75 ± 1134.09 cGy in C-Plan and 5061.03 ± 1121.09 cGy in R-Plan (p = 0.000), contralateral cochlea Dmean 4386.73 ± 945.14 cGy in C-Plan and 4991.38 ± 961.21 cGy in R-Plan (p = 0.000). Meanwhile, there was no significant difference in dose distribution in spinal cord, brainstem, and other OARs. Our dosimetry study showed cochlea sparing in intensity-modulated radiotherapy for NPC reduced cochlea dose to different extent, so we suggested a stratified scheme of cochlea sparing based on T stage could be a useful and practical tool for both physicists and radiation doctors.