Junjian Huang BS, Presenter: Nothing to Disclose

Joseph Kaminski MD, Abstract Co-Author: Nothing to Disclose

Jeff Campbell, Abstract Co-Author: Nothing to Disclose

Jing Zhao, Abstract Co-Author: Nothing to Disclose

Paul Stanton, Abstract Co-Author: Nothing to Disclose

Ahmad Al-Basheer PhD, Abstract Co-Author: Nothing to Disclose

Byron Grady Dasher MD, Abstract Co-Author: Nothing to Disclose

Jerry W. Howington MD, Abstract Co-Author: Nothing to Disclose

Jed Weems Howington MD, Abstract Co-Author: Nothing to Disclose

John Stewart, Abstract Co-Author: Nothing to Disclose

William Dean Martin MD, Abstract Co-Author: Nothing to Disclose

Chris Sheils MD, Abstract Co-Author: Nothing to Disclose

Feng-Ming Kong MD, PhD, Abstract Co-Author: Nothing to Disclose

Low total lymphocyte count and lymphocyte to neutrophil ratio are directly related to immunofunction and have been reported as poor prognostic indicators for multiple cancers at various stages after anticancer treatment. We hypothesized that baseline lymphocyte count and lymphocyte to neutrophil count correlate with overall survival in patients with head and neck cancer treated with radiation based therapy.

This is a retrospective analysis of consecutive patients with non-metastatic Stage I-IV head and neck cancer who were treated with radiation therapy from January of 2003 to October of 2013. Pre-treatment complete white blood count, demographic, and clinical variables were extracted from medical records and vital status was obtained by using the Social Security Death Index. Variables and outcomes were analyzed using tests of R.

Of the 348 patients reviewed, 254 had baseline complete blood counts (Median age 57, Male 178, Female 76, 201 received chemotherapy). The median follow-up duration is 22 months. Higher baseline lymphocyte count and lymphocyte to neutrophil ratio were significantly associated with lower mortality (HR: 0.34, 95% CI 0.23-0.53, p<0.000001 and HR: 0.91, 95% CI 0.84-0.97 p=0.005). The 2 year survival rates for patients with normal lymphocyte counts versus patients with abnormal counts were 65% (CI: 0.724-0.865, 0.567-0.745) and 61% (CI: 0.714-0.941, 0.476-0.783), respectively. Furthermore, higher neutrophils (HR: 1.07 95% CI 1.001-1.141, p=0.047) and seg counts (HR: 1.04, p=0.0007) were correlated with increased mortality. Stage IV cancer patients had worsened overall survival compared to Stage I-III (HR 2.2, CI: 1.3-3.6, P=0.0026). Other variables such as chemotherapy(HR: 0.7, P=0.174), age, and gender were not significantly associated with overall survival.

This study demonstrates that baseline lymphocyte count and lymphocyte to neutrophil ratio is directly correlated with overall survival in patients with head and neck cancers treated with radiation therapy. This result suggests immune function may play an important role in overall survival of head and neck patients. Prospective studies are needed to validate this interesting funding.

To advocate the property of pre-treatment baseline lymphocyte count and lymphocyte to neutrophil ratio as prognostic indicators for overall survival in HEENT cancer patients treated with radiation therapy.

Huang, J, Kaminski, J, Campbell, J, Zhao, J, Stanton, P, Al-Basheer, A, Dasher, B, Howington, J, Howington, J, Stewart, J, Martin, W, Sheils, C, Kong, F, Low Baseline Lymphocyte Count and Lymphocyte to Neutrophil Ratio May Predict Poorer Overall Survival in Patients with Head and Neck Cancer Treated with Radiation Therapy: Role of Immunofunction?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011790.html