Predictive value of immune-inflammation indices in terms of metabolic response and outcome after curative radiotherapy for non-small cell lung cancer

Lung Cancer

Ozkan EE, et al. Clin Respir J 2020.


INTRODUCTION: Role of systemic inflammation response in prognosis of several solid tumors has been evaluated in quite a lot of recent reports.

OBJECTIVES: In this study we aimed to investigate the effect of a novel immune response marker; systemic immune-inflammation index (SII) on metabolic response to chemoradiotherapy and outcome in patients with non-small cell lung cancer (NSCLC). Other several inflammatory indices such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) were also evaluated in terms of predictive value.

METHODS: Files of 66 newly diagnosed NSCLC patients who underwent curative radiotherapy were retrospectively analyzed. Factors correlated with overall survival was evaluated via univariate and multivariate survival analysis.

RESULTS: In 20.05 months of median follow up 22 (33.33%) patients were alive. Median overall survival, 3 and 5 years survival for the entire group were 25.49 (95% CI: 19.07-31.91) months, 54.9% and 20.1% respectively. Among investigated inflammatory indices, only low PNI (≤ 45.45), was found significantly correlated with poor response rate (p: 0,024). None of the prognostic factors and inflammatory indices were found statistically significant in terms of overall survival via univariate and multivariate analysis.

CONCLUSIONS: Immunoinflammatory indices are feasible prognostic indicators for clinical use with easily accessible components. In this study we demonstrated that pretreatment PNI ≤ 45,45 was statistically significant for predicting poor treatment response. None of the indices were significantly correlated with radiation pneumonitis.