Korean J Gastroenterol.  2022 Jun;79(6):252-259. 10.4166/kjg.2022.021.

Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Hepatocellular Carcinoma Treated with Stereotactic Body Radiotherapy

• Park Y
• Chang AR

• KMID: 2530698
• DOI: http://doi.org/10.4166/kjg.2022.021

Abstract

Purpose
To investigate the prognostic value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC) treated with stereotactic body radiotherapy (SBRT).
Methods
The medical records of HCC patients treated with SBRT between 2008 and 2019 were reviewed retrospectively. The NLR and PLR were calculated from the serum complete blood count before and after SBRT, and the prognostic values of the NLR and PLR for the treatment outcomes were evaluated.
Results
Thirty-nine patients with 49 HCC lesions were included. After a median follow-up of 26.8 months (range, 8.4-80.0 months), three-year local control, overall survival (OS), and progression-free survival (PFS) rate were 97.4%, 78.3%, and 35.2%, respectively. Both NLR and PLR increased significantly after SBRT and decreased slowly to the pre-SBRT value at 6 months. Univariable analysis showed that gross tumor volume (GTV) >14 cc, post-SBRT PLR >90, and PLR change >30 were associated with a poorer OS (p=0.002, p=0.011, and p=0.001, respectively), and the PLR change was significant in multivariable analysis (hazard ratio [HR], 10.09; 95% CI, 1.15-88.40; p=0.037). For PFS, GTV >14 cc, post-SBRT NLR >2.5 and post-SBRT PLR >90 were predictive of a poorer PFS in univariable analysis (p=0.011, p=0.004 and p=0.041, respectively) and only post-SBRT NLR >2.5 remained significant in multivariable analysis (HR, 2.44; 95% CI, 1.03-5.76; p=0.042, respectively).
Conclusions
The NLR and PLR increased transiently after SBRT, and the post-SBRT NLR and PLR were associated with the clinical outcomes of HCC patients.

Keyword

Carcinoma; hepatocellular; Neutrophil to lymphocyte ratio; Platelet to lymphocyte ratio; Prognosis

Figure

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  Fig. 1 (A) Overall survival and (B) progression-free survival after stereotactic body radiotherapy.

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  Fig. 2 (A) NLR and (B) PLR change after SBRT. NLR, neutrophil to lymphocyte ratio; PLR, platelet to lymphocyte ratio; SBRT, stereotactic body radiotherapy. aSignificantly increased (p<0.05) compared to the pre-SBRT value.

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  Fig. 3 Kaplan-Meier curves for the overall survival according to (A) PLR and progression-free survival according to (B) NLR. NLR, neutrophil to lymphocyte ratio; PLR, platelet to lymphocyte ratio; SBRT, stereotactic body radiotherapy.

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