Prognostic value of posttreatment neutrophil lymphocyte ratio in head and neck squamous cell carcinoma treated by chemoradiotherapy

Objective: An inflammatory-immunological marker, C-reactive protein (CRP), neutrophil-tolymphocyte ratio (NLR), was evaluated as a predictive marker of advanced head and neck cancer patients receiving chemoradiotherapy. Methods: This study included 104 patients with treatment-naive head and neck cancer who underwent definitive chemoradiotherapy. An inflammatory marker was measured at baseline and after 1 month of treatment. Univariate and multivariate analyses using Cox proportional hazards model were used to identify predictors of progression-free survival (PFS) and overall survival (OS). Results: A univariate analysis revealed that T,N-stage, the pre- and posttreatment NLRs were significant predictors of progression after the chemoradiotherapy. However, the posttreatment NLR remained an independent predictor of PFS in the multivariate analysis (HR = 2.23, 95% CI 1.15-2.321; P = 0.001). A high posttreatment NLR was significantly associated with an increased risk of death (HR = 1.87, 95% CI 0.89-3.31; P = 0.037). Conclusion: A high posttreatment NLR is associated with poor prognostic factor. An early reduction in the NLR after treatment may indicate survival improvement in the patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.