Exploring the role of neutrophil-to-lymphocyte ratio and blood chemistry in head and neck adenoid cystic carcinomas treated with carbon ion radiotherapy. (December 2022)

• Record Type: Journal Article
• Authors: Barcellini, Amelia; Fontana, Giulia; Filippini, Daria Maria; Ronchi, Sara; Bonora, Maria; Vischioni, Barbara; Ingargiola, Rossana; Camarda, Anna Maria; Loap, Pierre; Facchinetti, Nadia; Licitra, Lisa; Baroni, Guido; Orlandi, Ester
• Is Part Of: Radiotherapy and oncology. Volume 177(2022)
• Page Start: 143
• Page End: 151
• Publication Date: 2022-12
• Subjects: Adenoid cystic carcinoma -- Carbon ion radiotherapy -- Neutrophil-to-lymphocyte ratio -- NLR -- Hemoglobin; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2022.10.027
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: Recent literature reported NLR as a prognostic factor in various neoplasms treated with photon beam radiotherapy. There is no report about the role of NLR in adenoid cystic carcinomas (ACCs) treated with carbon ion radiotherapy (CIRT) ACC patients with higher pre-CIRT levels of NLR and hemoglobin > 14 g/dl had a predictable decrease in DFS. hemoglobin > 14 g/dL was a negative independent prognostic predictor for MFS. Abstract: Background and purpose: In recent years, there is an emerging interest in the prognostic role of chemistry blood biomarkers in oncological patients but their role in adenoid cystic carcinomas (ACCs) is still unknown. This study aims to assess the prognostic significance of baseline neutrophil-to-lymphocyte ratio (NLR) and blood chemistry in a series of head and neck ACC patients treated with carbon ion radiotherapy (CIRT). Material and Methods: We retrospectively retrieved the data of 49 consecutive head and neck ACC patients treated with CIRT. Univariable and multivariable Cox proportional hazard regression (Cox-ph) analyses were performed to look for a potential association of NLR, and other blood biomarker values, with disease-free survival (DFS), Local Control (LC), Metastasis Free Survival (MFS) and overall survival (OS). Results: No significant association between NLR > 2, 5 and DFS, LC, MFS and OS was found with univariable analysis although a trend was reported for DFS (Hazard ratio [HR]: 2, 10, 95 % CI: 0, 85 – 5, 08, p-value = 0, 11). Patients with hemoglobin (hb) ≤ 14 g/dL showed significantly better DFS, MFS and OS. Multivariable regression Cox-ph analysis for DFS, adjusted for margin status, clinical target volume and Absolute Number of Monocytes, reported the following statistically significant HRs, for both NLR > 2, 5 and hb > 14 g/dL respectively: 4, 850 (95 % CI = 1, 408 – 16, 701, p = 0, 012) and 3, 032 (95 % CI = 1, 095 – 8, 393, p = 0, 033). Moreover, hb > 14 with HR = 3, 69 (95 % CI: 1, 23 – 11, 07, p-value = 0, 02), was a negative independent prognostic predictor for MFS. Conclusions: Pre-treatment NLR and hb values seem to be independent prognostic predictor for clinical outcomes in head and neck ACC patients. If their role will be validated in a larger prospective cohort, they might be worthwhile for a pre-treatment risk stratification in patients treated with CIRT.