Predictive value of absolute lymphocyte count and its related parameters before treatment in patients with locally advanced cervical cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective:To investigate the prognostic value of absolute lymphocyte count (ALC) and neutrophil-lymphocyte ratio (NLR), macrophage-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) before treatment in patients with locally advanced cervical cancer (LACC).Methods:A total of 175 patients newly-diagnosed with LACC admitted to Cancer Hospital affiliated to Xinjiang Medical University from August 2016 to October 2019 were enrolled in this study. Complete clinical data and ALC before treatment were recorded and NLR, MLR and PLR were calculated. Multivariate Cox′s proportional hazard regression model was used to analyze the prognostic factors of patients with LACC.Results:The progress-free survival (PFS) of LACC patients in the NLR reduction group (<3.34) and MLR reduction group (<0.315) were significantly higher than those in the NLR and MLR elevation groups (both P<0.05). The overall survival (OS) of LACC patients in the ALC elevation group (≥1.375 × 10 9/L) and the PLR reduction group (<160.575) were significantly higher compared with those in the ALC reduction group and PLR elevation group (both P<0.05). Univariate analysis showed that EQD 2Gy, the equivalent dose of HR-CTV, was an important prognostic factor of PFS in patients with LACC ( P=0.030). Multivariate Cox′s regression analysis demonstrated that FIGO staging ( HR=2.339, 95% CI 1.22-4.48, P=0.010) and concurrent chemoradiotherapy ( HR=0.213, 95% CI 0.11-0.43, P<0.001) were the independent predicators of PFS in patients with LACC. However, concurrent chemoradiotherapy ( HR=0.229, 95% CI 0.07-0.81, P=0.023) and MLR ( HR=4.933, 95% CI 1.39-17.54, P=0.014) before treatment were the independent predictors of OS in patients with LACC. Conclusions:Patients with locally advanced cervical cancer can benefit from concurrent chemoradiotherapy. HR-CTV EQD 2Gy is a critical prognostic factor of PFS in patients with LACC. The increase of MLR before treatment is an independent prognostic factor of OS in LACC patients.