Longitudinal measurements of neutrophil-to-lymphocyte ratio in nasopharyngeal cancer treated with concurrent chemoradiotherapy

We study factors affecting neutrophil-to-lymphocyte ratio (NLR) and its changes throughout the treatment ([DELTA]NLR) of nasopharyngeal carcinoma (NPC) underwent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy (AC) and oncological outcomes including overall survival (OS) and disease-free survival (DFS). Data from 81 NPC patients was retrospectively evaluated. NLRs were obtained from first week of CCRT (pre-CCRT), last week of CCRT (end-CCRT), and at last cycle of AC (end-AC). Pre-CCRT NLR was categorized into "low" and "high". End-CCRT and end-AC [DELTA]NLRs were divided into "increased" and "decreased" based on NLR at these two timepoints relative to the value at pre-CCRT. Associations between sex, age, cancer stage and NLR, [DELTA]NLRs were investigated. OS and DFS were reported. Median NLR at pre-CCRT (2.47) was lower than NLR at end-CCRT (6.29) and end-AC (3.77) (P-value = 0.043). Advanced cancer stage associated with high pre-CCRT NLR (P-value = 0.047). Male gender was associated with "increased" end-CCRT [DELTA]NLR, whereas male gender and age [less than or equal to]51 were associated with "increased" end-AC [DELTA]NLR. Three-year OS and DFS rates were 85.25% and 76.39%, respectively. There were no statistically significant differences observed in OS and DFS among groups categorized by pre-CCRT NLR, [DELTA]NLRs, gender, age, and cancer stage. NLR increases during NPC treatment. Advanced staging is associated with higher baseline NLR. Increased [DELTA]NLR is associated with male gender at end-CCRT and male gender with age [less than or equal to]51 years at end-AC. No relation between NLR and its dynamic change with either OS or DFS was demonstrated.