Clinical significance of blood cell count in locally advanced unresectable NSCLC patients under different treatment modes
Objective To explore the pattern of blood cell changes in different treatment modalities and the relationship be-tween blood cell changes during radiotherapy and the prognosis of NSCLC patients.Methods A total of 208 patients with locally advanced unresectable non-small cell cancer(NSCLC)who received treatment at Shandong Cancer Hospital and In-stitute from July 5th,2018 to August 15th,2022 were selected as the study subjects.Clinical characteristic data and neu-trophil count,lymphocyte count,and neutrophil to lymphocyte ratio(NLR)under different treatment modes were col-lected,and the progression-free survival(PFS)of patients was calculated.Pearson linear correlation analysis was used to analyze the correlation between neutrophil count/baseline,lymphocyte count/baseline value,and NLR/baseline value with radiation therapy duration.Kaplan Meier method was used to plot survival curves.Results The mean neutrophil counts of 73 NSCLC patients before and after radiotherapy were(4.01±2.05)×109 L-1 and(2.84±1.76)×109 L-1,respectively,Z=3.29 and P<0.001.The mean lymphocyte counts before and after radiotherapy were(1.55±0.66)× 109 L-1 and(1.12±0.52)× 109 L-1,respectively,Z=3.89 and P<0.001.The mean NLR counts after and before ra-diotherapy were(4.53±2.37)×109 L-1 and(2.95±1.86)×109 L-1,respectively,Z=3.32 and P<0.001.Comparing the changes in blood cell count before and after chemotherapy or immunotherapy,there was a statistically significant difference in neutrophils(Z=3.72,P<0.001)and lymphocytes(Z=2.81,P=0.005)before and after treatment.After receiving immunotherapy alone,the average lymphocyte count of patients increased by about 0.19X 109 L-1,Z=3.36,P<0.001;The mean values of lymphocytes in patients receiving synchronous immunotherapy with chemotherapy before and after treatment were(1.42±0.50)× 109 L-1 and(1.25±0.90)×109 L-1,respectively,Z=3.62 and P<0.001.The neutrophil count/baseline value was negatively correlated with the duration of radiotherapy,r=-0.480,P=0.013;The lymphocyte count/baseline value was negatively correlated with the duration of radiotherapy,r=-0.480,P<0.001;The NLR was positively correlated with the duration of radiotherapy,r=0.190,P=0.014.Based on lymphocyte grouping,the median PFS of high-level and low-level patients was 20.1 and 10.7 months,respectively,x2=4.50,P=0.034;Grouping based on neutrophils grouping,the median PFS of high-level and low-level patients was 14.1 and 16.7 months,respectively,x2=0.50,P=0.470;Based on NLR grouping,the median PFS of high-level and low-level patients was 13.9 and 15.3 months,respectively,x2=0.10,P=0.820.Conclusion Chemotherapy mainly leads to a decrease in neutrophils,while radiotherapy mainly leads to a decrease in lymphocytes;Lymphocyte count/baseline value is a predic-tive indicator of PFS in locally advanced unresectable NSCLC patients receiving radiotherapy.