This retrospective cohort study enrolled patients with HNC, with the exception of those with oral and salivary gland cancer, who underwent treatment at Shinshu University Hospital between January 2014 and March 2021. Patients who underwent surgical treatment were excluded from this cohort. One hundred and twenty-four patients who received CRT and whose pre- and post-treatment hematological data were available were reviewed (Fig. 4 ). The clinicopathological data of the patients, including age, sex, Eastern Cooperative Oncology Group performance status (ECOG PS), current smoking status, primary tumor site, clinical stage (according to the 8th edition of the TNM classification), histology, p16 status, and hematological data were obtained from the medical records. Serum albumin and CRP were measured using the modified bromocresol purple method and latex coagulating nephelometry, respectively. The NLR, LMR, PLR, CAR, PNI, and PINI were calculated as follows: total neutrophil count (/mm3) divided by the total lymphocyte count (/mm3), total lymphocyte count (/mm3) divided by the total monocyte count (/mm3), platelet count (/mm3) divided by the total lymphocyte count (/mm3), serum CRP (mg/dL) divided by serum albumin (g/dL), 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm3), and 0.9 × serum albumin (g/dL) − 0.0007 × monocyte count (/mm3), respectively. These hematological markers were calculated based on blood tests conducted within 1 month from the first day of radiotherapy and within 1 week from the last day of radiotherapy. Pre- and post-treatment markers were termed as follows: pre-NLR, pre-LMR, pre-PLR, pre-CAR, pre-PNI, and pre-PINI for pretreatment markers and post-NLR, post-LMR, post-PLR, post-CAR, post-PNI, and post-PINI for post-treatment markers.![]()
Flow diagram of patient selection. HNC head and neck cancer, CRT chemoradiotherapy, BRT bioradiotherapy; RT radiotherapy, ICT induction chemotherapy, SCC squamous cell carcinoma, LEC lymphoepithelial carcinoma.
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