Are Neutrophil/Lymphocyte and Platelet/Lymphocyte Rates in Patients with Non-Small Cell Lung Cancer Associated with Treatment Response and Prognosis?

Background: Inflammation is a critical component of tumor progression. Many cancers arise from sites ofinfection, chronic irritation, and inflammation. It is now becoming clear that the tumour microenvironment,which is largely orchestrated by inflammatory cells, is an essential participant in the neoplastic process, promotingproliferation, survival and migration. Platelets can release some growth factors such as platelet-derived growthfactor, platelet factor 4, and thrombospondin. Such factors have been shown to promote hematogenous tumourspread, tumor cell adhesion and invasion, and angiogenesis and to play an important role in tumor progression.In this study, we aimed to investigate effects of the pretreatment neutrophil to lymphocyte ratio (NLR) and theplatelet to lymphocyte ratio (PLR) on survival and response to chemoradiotherapy in patients with non-small-celllung cancer (NSCLC). Materials and
Methods: Ninety-four patients with non-metastatic NSCLC were includedand separated into two groups according to median valuse of NLR and PLR (low:<3.44 or high:≥3.44 andlow:<194 or high≥194, respectively).
Results: Pretreatment high NLR and PLR were associated with significantlyshorter disease-free and overall survival rates. Multivariate analysis revealed that the overall survival rateswere significantly linked with PLR (OR: 1.87, CI: 1.20-2.91, p: 0.006) and response to chemoradiotherapy (OR:1.80, CI: 1.14-2.81, p: 0.012) and the disease-free survival rates were significantly associated with NLR (OR:1.81, CI: 1.16-2.82, p: 0.009) and response to chemoradiotherapy (OR: 2.30, CI: 1.45-3.66, p: 0.001). There wasno significant difference between patients with high and low NLR in terms of response to chemoradiotherapy.Similarly, there was no significant influence of the PLR.
Conclusions: Pretreatment NLR and PLR measurementscan provide important prognostic results in patients with NSCLC and assessment of the two parameters togetherappears to better predict the prognosis in patients with NSCLC. The effect of inflammation, indicators of NLRand PLR, on survival seems independent of the response to chemoradiotherapy.