C-reactive protein to albumin ratio as prognostic marker in locally advanced non-small cell lung cancer treated with chemoradiotherapy

  • Despite the implementation of consolidative immune checkpoint inhibition after definitive chemoradiotherapy (CRT), the prognosis for locally advanced non-small-cell lung cancer (NSCLC) remains poor. We assessed the impact of the C-reactive protein (CRP) to albumin ratio (CAR) as an inflammation-based prognostic score in patients with locally advanced NSCLC treated with CRT. We retrospectively identified and analyzed 52 patients with primary unresectable NSCLC (UICC Stage III) treated with definitive/neoadjuvant CRT between 2014 and 2019. CAR was calculated by dividing baseline CRP by baseline albumin levels and correlated with clinicopathologic parameters to evaluate prognostic impact. After dichotomizing patients by the median, univariate and multivariate Cox regression analyses were performed. An increased CAR was associated with advanced T-stage (p = 0.018) and poor performance status (p = 0.004). Patients with pre-therapeutic elevated CAR had significantly lower hemoglobin and higher leukocyte levels (hemoglobin p = 0.001, leukocytes p = 0.018). High baseline CAR was shown to be associated with worse local control (LPFS, p = 0.006), shorter progression-free survival (PFS, p = 0.038) and overall survival (OS, p = 0.022), but not distant metastasis-free survival (DMFS). Multivariate analysis confirmed an impaired outcome in patients with high CAR (LPFS: HR 3.562, 95% CI 1.294–9.802, p = 0.011). CAR is an easily available and independent prognostic marker after CRT in locally advanced NSCLC. CAR may be a useful biomarker for patient stratification to individualize treatment concepts.
Metadaten
Author:Alina Maria FreyGND, Daniel MartinORCiDGND, Louisa D'Cruz, Emmanouil FokasORCiDGND, Claus RödelORCiDGND, Maximilian FleischmannGND
URN:urn:nbn:de:hebis:30:3-823828
DOI:https://doi.org/10.3390/biomedicines10030598
ISSN:2227-9059
Parent Title (English):Biomedicines
Publisher:MDPI
Place of publication:Basel
Document Type:Article
Language:English
Date of Publication (online):2022/03/03
Date of first Publication:2022/03/03
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2024/02/27
Tag:C-reactive protein; CAR; CRT; NSCLC; albumin; biomarker; chemoradiotherapy; inflammation; predictive; prognostic
Volume:10
Issue:3, art. 598
Article Number:598
Page Number:12
First Page:1
Last Page:12
Institutes:Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International