The prevalence and prognostic value of systemic inflammation in good performance status patients with advanced, inoperable non‐small cell lung cancer receiving palliative radiotherapy: Comparison of composite ratios and cumulative scores

Introduction The present study sought to examine the relationships between systemic inflammatory composite ratios/cumulative scores, magnitude of systemic inflammatory response (SIR) and survival in good performance status patients (ECOG‐PS 0/1) with advanced NSCLC receiving palliative radiotherapy. Methods Systemic inflammatory composite ratios/cumulative scores included the neutrophil‐lymphocyte ratio (NLR), platelet‐lymphocyte ratio (PLR), lymphocyte‐monocyte ratio (LMR), C‐reactive protein, (CRP)‐albumin ratio (CAR), neutrophil‐ lymphocyte score (NLS), platelet‐lymphocyte score (PLS), lymphocyte‐monocyte score (LMS), neutrophil‐platelet score (NPS), modified Glasgow prognostic score (mGPS). The magnitude of SIR was determined by serum CRP concentration, with a median CRP concentration of >10 m mg/L considered to be systemically inflamed. Relationships between systemic inflammatory composite ratios/ cumulative scores and clinicopathological characteristics were examined using chi‐square analysis. Relationships between overall survival (OS) and systemic inflammatory composite ratios/ cumulative scores were examined using cox regression analysis. Results 479 patients were included. 48% (n = 231) of patients were male and 70% (n = 338) were ≥65 years of age. 29% (n = 140) patients were ECOG‐PS 0 and 71% (n = 339) were ECOG‐PS 1. 98% (n = 469) of patients died during follow‐up. The median survival was 5 months (2–11). A similar prevalence of systemic inflammation was noted across the various ratios/scores (NLR >3 68%; LMR 150 70%; CAR >0.20 83%; NLS ≥1 66%; LMS ≥1 71%; NPS≥1 50%; PLS≥1 60% and mGPS≥1 75%). Despite not considered to be systemically inflamed, an NLR 10 mg/L. When adjusted for ECOG‐PS, CAR>0.40 (p