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Original Research Article

Year: 2020 | Month: February | Volume: 7 | Issue: 2 | Pages: 173-178

Blood Parameters as Surrogate Markers to Predict Treatment Response after Radiation Therapy in Head and Neck Malignancies

Aathira T S¹, Sweety Gupta², Ajay S Krishnan³, Debanjan Sikdar¹, Sagar Raut¹, Nidhi Sharma¹, Naseef P K¹, Deepa Joseph⁴, Rajesh Pasricha⁵, Manoj Gupta⁶, Bela Goyal²

¹Junior Resident, ²Assistant Professor, ³Senior Resident, ⁴Associate Professor, ⁵Additional Professor, ⁶Professor and Head,
Dept. of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, India.

Corresponding Author: Aathira T S

ABSTRACT

Background: Several prognostic factors have been defined for Head and neck cancers that can influence response to therapy and eventual outcomes. Recent studies show that Neutrophil to Lymphocyte ratio (NLR) Platelet to Lymphocyte ratio (PLR) and Red blood cell distribution width (RDW)are hematologic makers that have started to show prognostic significance across many types of cancers.
Aim: Evaluate role of NLR, PLR and RDW as surrogate markers to predict treatment response in head and neck malignancies
Methodology: We retrospectively analysed stage II to IVB HNC treated with radical intent from Jan 2018 to Dec 2018 in the department of Radiation oncology. Inclusion criteria were new histologically confirmed head and neck squamous cell cancer.
Result: Out of 51patients analysed, 31 patients had complete response and 19 had residual/recurrence. Baseline RDW NLR and PLR ranged from10.2-20.1, 1.02-18.6 and 22.7-608.9 respectively. In complete response patients mean NLR was 2.0 (CI-1.78-2.21) which was significantly lower than mean NLR in disease which was 5.18 (CI-3.46-6.90). Mean PLR in complete response patients was 93.99 (CI-79.11-108.87) that was significantly lower than mean PLR in disease which was 218.47 (CI-158.59-278.35). There was a significantly higher RDW in disease patients with mean 16.0 (CI-15.13-16.87) than mean RDW in complete response patients which was 13.52 (CI-12.93-14.88).
Conclusion: NLR and PLR represent immunity status and also an indicator of prognosis of cancer patients. RDW is a marker of systemic inflammatory response. In our study elevated pre-treatment NLR, PLR and RDW predicted poor response to treatment.

Keywords: Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Red blood cell distribution width (RDW), Head and Neck radiotherapy

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