Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer

Radiotherapy (RT) is the standard of care following breast-conserving operation in breast cancer patients. The neutrophil-to-lymphocyte ratio (NLR) reflects the systemic change caused as a result of the radiotherapy. We aimed to evaluate the association between RT and the change in NLR following the...

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Autores principales: Yoon, Chang Ik, Kim, Dooreh, Ahn, Sung Gwe, Bae, Soong June, Cha, Chihwan, Park, Soeun, Park, Seho, Kim, Seung Il, Lee, Hye Sun, Park, Ju Young, Jeong, Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409084/
https://www.ncbi.nlm.nih.gov/pubmed/32674376
http://dx.doi.org/10.3390/cancers12071896
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author Yoon, Chang Ik
Kim, Dooreh
Ahn, Sung Gwe
Bae, Soong June
Cha, Chihwan
Park, Soeun
Park, Seho
Kim, Seung Il
Lee, Hye Sun
Park, Ju Young
Jeong, Joon
author_facet Yoon, Chang Ik
Kim, Dooreh
Ahn, Sung Gwe
Bae, Soong June
Cha, Chihwan
Park, Soeun
Park, Seho
Kim, Seung Il
Lee, Hye Sun
Park, Ju Young
Jeong, Joon
author_sort Yoon, Chang Ik
collection PubMed
description Radiotherapy (RT) is the standard of care following breast-conserving operation in breast cancer patients. The neutrophil-to-lymphocyte ratio (NLR) reflects the systemic change caused as a result of the radiotherapy. We aimed to evaluate the association between RT and the change in NLR following the receipt of RT, and to investigate the prognostic impact. We retrospectively reviewed NLR values of breast cancer patients taken before the administration of the first and the last session of RT. The cut-off point for the NLR was determined using the Youden index and receiver operating characteristic (ROC) curve within the training set. Recurrence-free survival (RFS), distant metastasis free survival, and overall survival were the main outcomes. Patients with an NLR higher than 3.49 after RT were classified to an RT-induced high NLR group and showed a significantly higher recurrence rate compared to those with low NLR (p < 0.001). In a multivariate Cox proportional hazards model, RT-induced high NLR remained a significant prognostic factor (HR 2.194, 95% CI 1.230–3.912, p = 0.008 for tumor recurrence. We demonstrated that an increase in NLR over the course of RT has a negative impact on survival, putting these patients with RT-susceptible host immunity at a higher risk of tumor recurrence.
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spelling pubmed-74090842020-08-26 Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer Yoon, Chang Ik Kim, Dooreh Ahn, Sung Gwe Bae, Soong June Cha, Chihwan Park, Soeun Park, Seho Kim, Seung Il Lee, Hye Sun Park, Ju Young Jeong, Joon Cancers (Basel) Article Radiotherapy (RT) is the standard of care following breast-conserving operation in breast cancer patients. The neutrophil-to-lymphocyte ratio (NLR) reflects the systemic change caused as a result of the radiotherapy. We aimed to evaluate the association between RT and the change in NLR following the receipt of RT, and to investigate the prognostic impact. We retrospectively reviewed NLR values of breast cancer patients taken before the administration of the first and the last session of RT. The cut-off point for the NLR was determined using the Youden index and receiver operating characteristic (ROC) curve within the training set. Recurrence-free survival (RFS), distant metastasis free survival, and overall survival were the main outcomes. Patients with an NLR higher than 3.49 after RT were classified to an RT-induced high NLR group and showed a significantly higher recurrence rate compared to those with low NLR (p < 0.001). In a multivariate Cox proportional hazards model, RT-induced high NLR remained a significant prognostic factor (HR 2.194, 95% CI 1.230–3.912, p = 0.008 for tumor recurrence. We demonstrated that an increase in NLR over the course of RT has a negative impact on survival, putting these patients with RT-susceptible host immunity at a higher risk of tumor recurrence. MDPI 2020-07-14 /pmc/articles/PMC7409084/ /pubmed/32674376 http://dx.doi.org/10.3390/cancers12071896 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yoon, Chang Ik
Kim, Dooreh
Ahn, Sung Gwe
Bae, Soong June
Cha, Chihwan
Park, Soeun
Park, Seho
Kim, Seung Il
Lee, Hye Sun
Park, Ju Young
Jeong, Joon
Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer
title Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer
title_full Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer
title_fullStr Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer
title_full_unstemmed Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer
title_short Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer
title_sort radiotherapy-induced high neutrophil-to-lymphocyte ratio is a negative prognostic factor in patients with breast cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409084/
https://www.ncbi.nlm.nih.gov/pubmed/32674376
http://dx.doi.org/10.3390/cancers12071896
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