Inflammation may play an important role in cancer progression, and a high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a indicator of poor prognosis in several malignancies. Platelet to lymphocyte ration (PLR), another inflammatory marker, also has prognostic value in some solid tumors. We determined the prognostic significance of baseline blood NLR and PLR in patients with glioblastoma.
A total of 118 patients with glioblastoma treated with concurrent chemoradiotherapy at our institution were retrospectively analyzed. Clinical information was obtained from electronic medical records. Patients were divided into cohorts dependent on whether they were taking Dexamethasone at baseline as this is known to affect the NLR. Cox proportional hazards models, adjusted for age and sex, were used to examine the survival effect of pre-treatment NLR and PLR in these patients. Kaplan-Meier analysis was used to plot overall survival. Using a median split, the NLR was classified as ≤4 and >4 and the PLR was classified as ≤155 and >155.
In the 54 patients not on Dexamethasone elevated NLR was significantly associated with risk of death (HR=2.36, p=0.018). In patients taking dexamethasone (63 patients) there was no increase in risk (HR=1.12, p=0.75). The PLR was not significantly associated with an increased risk of death regardless of Dexamethasone use.
NLR but not PLR could be a convenient, easily measured prognostic indicator for patients with glioblastoma who are not on Dexamethasone.