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- Title
Neutrophil–lymphocyte ratio dynamics are useful for distinguishing between recurrence and pseudoprogression in high-grade gliomas.
- Authors
Huang, Yong; Ding, Haixia; Wu, Qiuji; Li, Zhiqiang; Li, Huan; Li, Sirui; Xie, Conghua; Zhong, Yahua
- Abstract
aimed to assess the predictive value of NLR in the differential diagnosis of recurrence and pseudoprogression. Materials and Methods: A total of 135 patients with histologically confirmed HGGs were studied. All patients underwent focal radiotherapy and concomitant temozolomide (TMZ), followed by 6 cycles of TMZ if MRI showed no progressive enlargement of contrast-enhancing lesions. MRI evaluation was taken 4 weeks after concurrent chemoradiotherapy and then every 2 months later. NLR was calculated at 4 time points of preoperation, before concurrent RT-TMZ (pretreatment), 4 weeks following completion of RT-TMZ, and MRI showed lesion enlarged or treatment completed. Results: In 135 patients, 47 (34.8%) were found to be pseudoprogression (PsPD), and 28 (20.7%) were early disease progression (ePD). The mean pretreatment and post-treatment NLR were 4.2±2.1 and 5.1±3.5, respectively. The median overall survival in the PsPD group (25.2 months) was significantly longer than in the ePD (15.4 months) and no progression group (nPD) (21.6 months) (p<0.001). Overall survival was significantly shorter in the baseline NLR≥4 cohort compared with NLR<4 (p=0.03), but no significant difference was found between PsPD and ePD (p=0.197). Patients with decreased NLR showed significantly longer survival than no decreased group (p<0.001), and decreased NLR was found to be a significant difference between PsPD and ePD (p=0.022). Univariate and multivariate logistic regression analyses suggested that decreased NLR was an independent prognosis factor (p=0.031). Conclusion: Decreased NLR is an independent prognostic factor and is useful for distinguishing between recurrence and pseudoprogression in HGGs.
- Publication
Cancer Management & Research, 2019, Vol 11, p6003
- ISSN
1179-1322
- Publication type
Article
- DOI
10.2147/CMAR.S202546