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

Abstract Objective An inflammatory-immunological marker, C-reactive protein (CRP), neutrophil-to-lymphocyte 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-naïve 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.