Journal article
Albumin and Neutrophil-Lymphocyte Ratio (NLR) Predict Survival in Patients With Pancreatic Adenocarcinoma Treated With SBRT
American journal of clinical oncology, Vol.41(3), pp.242-247
03/01/2018
DOI: 10.1097/COC.0000000000000263
PMID: 26757436
Abstract
Purpose:To determine if pretreatment nutritional status and inflammatory markers correlate with survival in patients with locally advanced pancreatic adenocarcinoma treated with stereotactic body radiotherapy (SBRT).Materials and Methods:We retrospectively reviewed 208 patients with newly diagnosed, locally advanced pancreatic adenocarcinoma treated with SBRT at our institution from 2002 to 2014. Laboratory values were collected before SBRT, including hemoglobin, platelets, albumin, red blood cell, white blood cell, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, and tumor markers CA 19-9 and CEA. Patients were followed every 3 months with computed tomography (CT) and/or positron emission tomography-CT imaging to monitor for local recurrence and overall survival (OS).Results:Median follow-up after SBRT was 7.5 months (interquartile range, 4.6 to 12.0 mo) for all patients. Median OS for patients with NLR>5 compared with NLR5 was 6.9 and 8.5 months, respectively (P=0.0057). On univariate analysis, receipt of chemotherapy (P=0.05, hazard ratio [HR]=0.69), increased albumin (P=0.002, HR=0.64), increased red blood cell (P=0.05, HR=0.75), increased lymphocyte count (P=0.002, HR=0.66), decreased CEA (P=0.01, HR=0.96), and NLR5 (P=0.01, HR=0.65) correlated with improved OS. On multivariate analysis, higher albumin (P=0.03, HR=0.70), receipt of chemotherapy (P=0.007, HR=0.56), and NLR5 (P=0.02, HR=0.66) correlated with better survival.Conclusions:Preradiotherapy low albumin levels and NLR>5 correlate with decreased survival in patients with locally advanced pancreatic adenocarcinoma treated with SBRT, indicating the prognostic value of systemic inflammatory markers (such as NLR) and a role of nutritional supplementation to improve outcomes in these patients. Further investigation is warranted.
Details
- Title: Subtitle
- Albumin and Neutrophil-Lymphocyte Ratio (NLR) Predict Survival in Patients With Pancreatic Adenocarcinoma Treated With SBRT
- Creators
- Muthuraman Alagappan - Stanford UniversityErqi L. Pollom - Stanford UniversityRie von Eyben - Stanford UniversityMargaret M. Kozak - Stanford UniversitySonya Aggarwal - Stanford UniversityGeorge A. Poultsides - Stanford UniversityAlbert C. Koong - Stanford UniversityDaniel T. Chang - Stanford University
- Resource Type
- Journal article
- Publication Details
- American journal of clinical oncology, Vol.41(3), pp.242-247
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/COC.0000000000000263
- PMID
- 26757436
- ISSN
- 0277-3732
- eISSN
- 1537-453X
- Number of pages
- 6
- Language
- English
- Date published
- 03/01/2018
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984313094002771
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