免疫巩固治疗前NLR、PLR与Ⅲ期老年非小细胞肺癌病人预后的相关性

doi:10.3969/j.issn.1003-9198.2023.11.010

Abstract

Abstract: Objective To investigate the correlation of neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio (PLR) with the prognosis in the elderly patients with stage Ⅲ non-small cell lung cancer (NSCLC) treated with radical chemo radiotherapy (CRT) followed by immune consolidation therapy. Methods A total of 83 elderly patients with stage Ⅲ NSCLC admitted to Radiotherapy Department of Jiangsu Cancer Hospital who received radical CRT followed by programmed cell death protein (PD-1) inhibitor consolidation therapy were enrolled. The baseline data and hematological parameters of all patients were collected. X-tile software was used to select the best threshold values of NLR and PLR in the 83 patients. Progression-free survival (PFS) and overall survival (OS) were assessed by Kaplan-Meier. And log-rank test was used to compare OS and PFS between subgroups. The correlation of the baseline characteristics and hematological parameters with prognosis were assessed by univariate and multivariate Cox regression analysis. Results In this study, the median follow-up time was 16.3 months, and the median PFS was 15.2 months, and the median OS was 29.0 months. The best cut-off values of NLR and PLR predicting PFS and OS were 3 and 196 respectively. Subgroup analysis showed that low NLR and low PLR were associated with good PFS (HR=0.33, 95%CI:0.18-0.61, P<0.01; HR=0.32, 95%CI:0.18-0.58, P<0.01) and OS (HR=0.35, 95%CI:0.15-0.85, P＜0.05; HR=0.22, 95%CI:0.09-0.54, P<0.01). Cox regression analysis showed PLR were associated with PFS, and ALC, were associated with OS. Conclusions Elderly patients with stage Ⅲ NSCLC who have undergone radical CRT are likely to benefit from subsequent immunotherapy. Low levels of NLR and PLR before PD-1 inhibitor therapy are associated with a better prognosis in the elderly patients, and PLR may be a prognostic indicator for PD-1 inhibitor consolidation therapy.

Key words: neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, non-small cell lung cancer, aged, radical chemoradiotherapy, programmed cell death protein1 inhibitor

CLC Number:

R 734.2

WANG Tian, YE Jin-jun, LI Hui, SHI Shu-tong, ZHANG Zhi, ZHOU Guo-ren, WANG Qiang, ZHANG Rong-rong, HE Xia. Correlation of NLR and PLR before immune consolidation therapy with prognosis in elderly patients with stage Ⅲ non-small cell lung cancer[J]. Practical Geriatrics, 2023, 37(11): 1120-1124.

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Correlation of NLR and PLR before immune consolidation therapy with prognosis in elderly patients with stage Ⅲ non-small cell lung cancer

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