Total lymphocyte count, neutrophil–lymphocyte ratio, and platelet–lymphocyte ratio as prognostic factors in advanced non–small cell lung cancer with chemoradiotherapy

OBJECTIVE: The objective of this study was to investigate the prognostic significance and the efficacy evaluation of total lymphocyte count (TLC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in advanced non–small cell lung cancer (NSCLC) patients treated with chemoradiotherapy. PATIENTS AND METHODS: A total of 389 advanced NSCLC patients who received chemoradiotherapy from 2011 to 2016 were enrolled in this retrospective study. TLC, NLR, and PLR were analyzed with overall survival (OS). Survival data were identified with the Kaplan–Meier method and optimal cutoff values with receiver operating characteristic curves. RESULTS: The median OS for all patients was 18.37 months. Pretreatment and median baseline TLC was 2.47×10(3)/μL (±0.78); NLR, 3.15 (±3.96); and PLR, 143.82 (±91.77); corresponding cutoffs were 2.4, 3.4, and 136.1. Higher TLC was associated with superior median OS (21.78 vs 15.66 months, P<0.001), and higher NLR and PLR with worse median OS (NLR: 14.13 vs 23.8 months, P<0.001; PLR: 15.49 vs 22.04 months, P<0.001). CONCLUSION: The lymphopenia indicators (TLC, NLR, and PLR) were significant prognostic indicators of survival in advanced NSCLC patients treated with chemoradiotherapy.