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Cited 20 time in webofscience Cited 21 time in scopus
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Neutrophil-lymphocyte ratio and a dosimetric factor for predicting symptomatic radiation pneumonitis in non-small-cell lung cancer patients treated with concurrent chemoradiotherapy

Authors
Lee, Yun HeeChoi, Hoon-SikJeong, HojinKang, Ki MunSong, Jin HoLee, Won SupLee, Gyeong-WonSong, Haa-NaKim, Hoon-GuKang, Myoung HeeRhee, Dong YoonJeong, Bae Kwon
Issue Date
Mar-2018
Publisher
WILEY
Keywords
lymphocyte; neutrophil; non-small cell lung cancer; radiation pneumonitis
Citation
CLINICAL RESPIRATORY JOURNAL, v.12, no.3, pp 1264 - 1273
Pages
10
Indexed
SCIE
SCOPUS
Journal Title
CLINICAL RESPIRATORY JOURNAL
Volume
12
Number
3
Start Page
1264
End Page
1273
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/11846
DOI
10.1111/crj.12660
ISSN
1752-6981
1752-699X
Abstract
ObjectivesTo identify the factors that predict the progression of radiological radiation pneumonitis (RP) to symptomatic RP, and to evaluate the usefulness of the neutrophil-lymphocyte ratio (NLR) as a marker of RP severity and prognosis in stage III non-small cell lung cancer (NSCLC) patients treated with definitive concurrent chemoradiotherapy (CCRT). Materials and MethodsWe retrospectively reviewed 61 patients treated between January 2010 and December 2015. Patients' demographic characteristics, clinical data, laboratory findings and treatment parameters were analyzed to determine the predictive factors associated with progression from radiological RP to symptomatic RP. ResultsForty-seven patients (77%) exhibited radiological RP at a median of 78 days after radiation therapy (RT) completion, and 15 (32%) of these patients developed symptomatic RP. The interval between RT completion and radiological RP presentation was shorter in patients who progressed to symptomatic RP (P=.001); progression was highly probable if this latency period was 2 months (P=.002). Stage and RT technique correlated with symptomatic RP development (P=.046 and P=.046, respectively). Among dosimetric factors, a V-20 (defined as the lung volume receiving 20 Gy) of >30% was the most significant predictor of symptomatic RP (P=.001). The NLR and C-reactive protein level at radiological RP were higher in patients who developed symptomatic RP (P=.067 and P=.012, respectively). On multivariate analysis, a V-20 >30% and an NLR at radiological RP >6 were associated with symptomatic RP development. ConclusionThe NLR at radiological RP is a useful biomarker for predicting symptomatic RP development after CCRT in stage III NSCLC patients.
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