Dynamic changes of hematological indices in oropharyngeal cancer patients treated with radiotherapy

Abstract

Background

Hematological indices assist in predicting clinical outcomes.

Objectives

To explore changes of hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients received radiotherapy and their association with survival.

Material and methods

The white blood cell count (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline, 1-, 3-, 6- and 12-months follow-up were retrospectively collected. The trajectory of indices was described. A linear model with random effects was to describe indices’ changing rate and trend. Univariable Cox analysis was to assess the correlation between indices and survival.

Results

Of the 85 patients, WBC and ALC dropped during acute phase and gradually recovered, while NLR and PLR increased during acute phase and subsequently declined (all p < .01). Higher absolute value of nutritional indices (Alb and Hb) was associated with better prognosis (p < .05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (ANC, Plt, NLR and PLR) had worse survival (p < .05).

Conclusions and significance

The short- and long-term changes of indices differed in OPSCC patients received radiotherapy, and absolute values and dynamic changes of indices had the potential to be prognostic factors.

Chinese Abstract

背景：血液学指数有助于预测临床结果。

目的：探讨接受放射治疗的口咽鳞状细胞癌(OPSCC)患者的血液学指数的变化及其与生存的关联。

材料与方法：回顾性收集了基线、1、3、6 和 12 个月随访时的白细胞计数（WBC）、中性粒细胞绝对计数（ANC）、淋巴细胞绝对计数 (ALC)、血红蛋白 (Hb)、血小板 (Plt)、白蛋白 (Alb)、中性粒细胞与淋巴细胞的比率（NLR）和血小板与淋巴细胞比值（PLR）。描述了这些指数的轨迹。具有随机效应的线性模型用于描述指数的变化率和趋势。单变量 Cox 分析用于评估指数和生存之间的相关性。

结果：85例患者在急性期WBC、ALC下降, 尔后逐渐恢复, 而NLR 和 PLR 在急性期上升, 随后下降（ p < .01）。较高的营养指数（Alb 和 Hb）绝对值与较好的预后相关（p < .05）。相比之下, 炎症指标（ANC、Plt、NLR、PLR）绝对值较高或呈上升趋势的患者生存率较差 (p < .05)。

结论与意义：接受放疗的OPSCC患者的指标的短期和长期变化存在着差异, 指标的绝对值和动态变化具有潜在的预后因素。

Keywords:

• Hematological indices
• oropharyngeal cancer
• radiotherapy
• NLR
• PLR

Disclosure statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Competing interests

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethics approval

This retrospective study has been approved by the institutional review board of West China Hospital of Sichuan University Biochemical Research Ethics Committee (No.2019-357).

Consent

The informed consents were waived.

Data transparency

All authors are requested to make sure that all data and materials as well as software application or custom code support their published claims and comply with field standards.

Additional information

Funding

This work was supported by West China Hospital, Sichuan University [ZY, grant #2019HXFH003, grant #ZYJC21027, RJJ, grant #2019HXBH079]; Chengdu Science and Technology Bureau [RJJ, grant #2019-YF05-00461-SN]; Sichuan University [ZY, grant #GSALK2020021, RJJ, grant #2020SCU12049]; The Science and Technology Department of Sichuan Province [ZY, grant #2020YFH0090, RJJ, grant #2020YFS0111, ZYB, grant #2022YFS0066]; The Health Department of Sichuan Province [RJJ, grant #20PJ030]; China Postdoctoral Science Foundation [RJJ, grant#2020M673250]; National Natural Youth Science Foundation of China [RJJ, grant #82002868].