Metastatik kanser hastalarında tedavi seciminde nötrofil-lenfosit oranı yol gösterici olabilir: Kemoterapi veya en iyi destekleyici bakım

Neutrophil-to-lymphocyte ratio may guide the choice of treatment in metastatic cancer patients: Chemotherapy or best supportive care

Özet

Amaç: Bu çalışmada nötrofil-lenfosit oranının (NLO), metastaik kanser hastaları için palyatif kemoterapiye devam etme veya en iyi destekleyici bakımı (BSC) seçme konusunda bir belirleyici olup olmadığını araştırmayı amaçladık. Yöntemler: Palyatif kemoterapi sonrası ölen metastatik kanser tanılı hastalar çalışmaya dahil edildi. Hastalar son kemoterapi rejimlerinin başlangıcı ile ölüm (DCD) arasındaki süreye göre ≤ 60 veya > 60 güne göre iki gruba ayrıldı. Nötrofil-lenfosit oranı, son kemoterapi hattı başlangıcından öncesindeki laboratuvar değerleri kullanılarak hesaplandı. ≤ 60 günlük DCD'nin belirleyici faktörleri lojistik regresyon analizi ile incelendi ve istatistiksel anlamlılık düzeyi alfa p

Abstract

Aim: We set out in this study to investigate whether the neutrophil-to-lymphocyte ratio is a predictor in deciding whether to either continue palliative chemotherapy or choose the best supportive care for advanced cancer patients.Methods: Those with advanced solid tumors who had died after palliative chemotherapy were included the study. The patients were divided into two groups based on the time between the beginning of their last chemotherapy regimen and death, at ≤ 60 or > 60 days. Neutrophil-to-lymphocyte ratio was calculated using thelaboratory values taken before the beginning of the last chemotherapy line. The determinant factors of ≤ 60-days survival were examined by logistic regression analysis, and a statistical significance level of alpha was accepted as p < 0.05.Results: The study included 404 patients, with the mean age at diagnosis of 61.7±12.0 years. The mean neutrophil-to-lymphocyte ratio was calculated as 11.3±27.1. In the univariate analysis for determining ≤ 60-days survival, breast and colorectal cancers, ECOG status, single agent chemotherapy usage, neutrophil count, lymphocyte count and neutrophil-to-lymphocyte ratio were all found to be significant factors. The cutoff value determining the ≤ 60-days DCD, was determined as NLR ≥ 3.59. In logistic regression analysis, NLR ≥ 3.59, as well as ECOG status, were found to be significant factors.Conclusion: The neutrophil-lymphocyte ratio, combined with ECOG, can predict survival in patients with solid advanced tumors and can therefore help clinicians in choosing to either administer chemotherapy to their patients or direct them to the best supportive care.