Journal of the Chinese Medical Association : JCMA | 2019
Platelet-lymphocyte and neutrophil-lymphocyte ratios: predictive factors of response and toxicity for docetaxel-combined induction chemotherapy in advanced head and neck cancers.
Abstract
BACKGROUND\nAlthough the effect of induction chemotherapy (IC) is still controversial in cancers of the oral cavity, the oropharynx, and the sinonasal tract, it is still used in some inoperable cases and for organ preservation in laryngeal or hypophryngeal cancers. Taxane has played a greater role and produces a better overall response but a higher rate of acute toxicity. We investigated the response and risk of IC with docetaxel-combined regimens in advanced head and neck cancers.\n\n\nMETHODS\nWe retrospectively reviewed the medical history of patients with advanced head and neck cancer between 2011 and 2017. We enrolled 40 patients who completed the initial tumor survey, ICs with docetaxel-combined regimens, and definite therapeutic strategies including concurrent chemoradiation or surgery. The demographic data, laboratory results, overall response, and acute toxicity were analyzed.\n\n\nRESULTS\nThere were 14 patients (35.0%) with partial response at least. There were 24 (60.0%) with at least one acute toxicity beyond grade III. Univariate analysis and multivariate linear regression analysis showed that a platelet-lymphocyte ratio (PLR) <8.5 correlates with a better overall response (p < 0.05), and a neutrophil-lymphocyte ratio (NLR) ≧ 3.5 correlates with a higher possibility of severe acute toxicity within one month after ICs (p<0.05), especially hematologic side effects.\n\n\nCONCLUSION\nA pre-treatment PLR <8.5 could predict better overall response, and a pre-treatment NLR ≧ 3.5 could predict more severe acute toxicity after docetaxel-combined ICs. Through a simple hematological examination, we could try to identify a better response of tumor regression and anticipate potentially harmful side effects after ICs.