Role Of Dynamic Detection Of Immunological Biomarkers In Peripheral Blood In Prognostic Survival For Patients With Advanced Non-small Cell Lung Cancer Who Received Chemoradiotherapy

Objective:To investigate the role of dynamic detection of immunological biomarkers in peripheral blood in prognostic survival for patients with advanced non-small cell lung cancer who received chemoradiotherapy.Methods:A retrospective review was conducted from September 2016 to June 2017.Patients with advanced NSCLC treated with chemoradiotherapy in the First Oncology Department of Shengjing Hospital of China Medical University were enrolled and excluded as follows:?1?Patients with locally advanced NSCLC?LA-NSCLC?who accepted platinum-plus-chemotherapy and patients with metastatic NSCLC?mNSCLC?who underwent radical radiotherapy?or chemoradiotherapy?;?2?The peripheral blood were detected before and after therapy,the test items was included the neutrophil to lymphocyte ratio?NLR?,the platelet to lymphocyte ratio?PLR?and lymphocyte subsets?the percentages of CD3+,CD4+,CD8+,CD16+CD56+,CD19+?;?3?The collected data mainly included clinic-pathological materials,therapeutic effectiveness and survival follow-up;?4?The follow-up time was more than 6 months and the deadline was December 30th,2017.Univariate analysis,Kaplan-Meier survival curve and Cox regression analysis were used to analyze the role of dynamic detection of immunological biomarkers in peripheral blood in prognostic survival for patients with advanced non-small cell lung cancer.Results:A total of 77 patients with advanced NSCLC were retrospectively analyzed.Among them,57 received first-line platinum-based doublet chemotherapy and 19received radical radiotherapy?or chemoradiotherapy?.The median progression free survival time?mPFS?for all patients was 11.6 months?95%CI:8.96-14.30?.Univariate analysis showed that low pretreatment CD3+?%?,low difference before and after treatment???CD4+/CD8+,low?CD16+CD56+,high Karnofsky Performance Score?KPS?,adenocarcinoma of pathological type,peripheral type of tumor location,no lymph node metastasis,no distant metastasis,low NLR and low PLR were significantly associated with long PFS,P_all<0.05;low?CD3+has a correlation with long mPFS,P=0.080<0.1.Further multivariate analysis identified that pretreatment CD3+,?CD3+,tumor location and KPS score were independent prognostic factors for progression,The HR were 4.20?95%CI:1.05-16.43,P=0.039?,4.81?95%CI:1.11-20.90,P=0.036?,15.84?95%CI:8.95-19.53,P=0.010?,and 0.84?95%CI:0.75-0.93,P=0.001?.Patients with low pretreatment CD3+?CD3+?%??76.40%?vs high CD3+?CD3+?%?>76.40%?,mPFS were 11.6months?95%CI:7.63-15.63?vs 5.7 months?95%CI:5.49-5.97??P<0.05?.Patients with low?CD3+??CD3+?%??6.05%?vs high?CD3+??CD3+?%?>6.05%?,mPFS were 11.6 months?95%CI:8.05-15.22?vs 6.2 months?95%CI:4.40-8.00??P<0.05?.Conclusion:The changes of lymphocyte subsets before and after treatment in patients with advanced non-small cell lung cancer have clinical value in prognostic survival.The pretreatment CD3+?%?and the?CD3+?%?are independent prognostic factors for disease progression after chemoradiotherapy in advanced and metastatic NSCLC patients.