Association of pretreatment neutrophil-to-lymphocyte ratio (NLR) and overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with first-line docetaxel.
Association of pretreatment neutrophil-to-lymphocyte ratio (NLR) and overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with first-line docetaxel.
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DOI：
10.1111/bju.12531
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发表时间：
2014-12
影响因子：
4.5
通讯作者：
Antonarakis ES
中科院分区：
文献类型：
--
作者：
Nuhn P;Vaghasia AM;Goyal J;Zhou XC;Carducci MA;Eisenberger MA;Antonarakis ES
为了确定治疗前中性粒细胞/淋巴细胞比率(NLR)是否与接受多西紫杉醇化疗的转移性去势耐受前列腺癌(MCRPC)患者的总生存期(OS)相关。回顾了1998至2010年间在一个大容量中心接受含多西他赛一线化疗的238名mCRPC患者的记录(这些患者有足够的信息来计算NLR)。用单因素和多因素COX回归模型预测化疗开始后的OS。在单变量分析中，NLR作为离散变量(最佳阈值3.0)与OS显著相关(P=0.001)。在多变量分析中，较低的NLR值(≤3.0)与较低的全因死亡率相关(P=0.002)。在Kaplan-Meier分析中，没有NLR升高的患者的中位OS(18.3个月比14.4个月)高于NLR升高的患者(对数等级；P<；0.001)。接受一线多西紫杉醇治疗的mCRPC患者治疗前NLR值(≤3.0)较低，其OS显著延长。在预测接受多西他赛治疗的男性mCRPC患者的OS时，NLR可能是一个潜在有用的全身炎症反应的临床标志物，并可能有助于对患者进行临床试验。这些来自回溯性分析的发现需要在更大的人群中、在前瞻性研究中以及在不同疗法的背景下进行验证。
To determine whether the pretreatment neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammatory response, is associated with overall survival (OS) in men receiving chemotherapy with docetaxel for metastatic castration-resistant prostate cancer (mCRPC). Records from 238 consecutive patients who were treated with first-line docetaxel-containing chemotherapy for mCRPC at a single high-volume centre from 1998 to 2010 (and who had adequate information to enable calculation of NLR) were reviewed. Univariable and multivariable Cox regression models were used to predict OS after chemotherapy initiation. In univariable analyses, the NLR as a discrete variable (optimal threshold 3.0) was significantly associated with OS (P = 0.001). In multivariable analyses, a lower NLR (≤3.0) was associated with lower risk of all-cause mortality (P = 0.002). In Kaplan-Meier analysis, the median OS was higher (18.3 vs 14.4 months) in patients that did not have an elevated NLR than in those with an elevated NLR (log-rank; P < 0.001). Men who were treated with first-line docetaxel for mCRPC who had a low pretreatment NLR (≤3.0) had significantly longer OS. NLR may be a potentially useful clinical marker of systemic inflammatory response in predicting OS in men with mCRPC who receive docetaxel and may be helpful to stratify patients for clinical trials. These findings derived from a retrospective analysis need to be validated in larger populations in prospective studies, and in the context of different therapies.
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