The effect of neutrophil-lymphocyte ratio on neck nodule size in nasopharyngeal carcinoma chemotherapy

Soehartono -, Dwi Novitasari, Iriana Maharani

Abstract


ABSTRACT

Background: Nasopharyngeal carcinoma (NPC) is a cancer of the head and neck, that ranks as the 4th most malignant cancer in Indonesia. The prognosis of NPC patients is determined from the clinical stage based on the Tumor, Nodule, Metastatic (TNM) classification system. These prognosis factors are not entirely reliable for predicting treatment outcomes. The Neutrophil Lymphocyte Ratio (NLR) represents an index of pro-tumor and anti-tumor activity, that can be used to predict the outcome of neoadjuvant chemotherapy and the patient’s well-being as assessed by Karnofsky status, Body Mass Index (BMI), and neck nodule size (NNS). Purpose: To study the effect of NLR on Karnofsky status, BMI, and NNS in WHO type III NPC patients who underwent 3 cycles of neoadjuvant chemotherapy. Method: Analytical observational research with a cohort-retrospective approach on WHO type III NPC subjects who underwent platinum-based regimen neoadjuvant chemotherapy. NLR pre-chemotherapy was analyzed for its effect on Karnofsky status, BMI, and NNS. Result: NLR had no significant effect on Karnofsky status pre- and post-chemotherapy, BMI pre- and post-chemotherapy, NNS pre-chemotherapy, changes in Karnofsky status and BMI pre-and post-chemotherapy, but had significant effect on the size of neck nodules post-chemotherapy, and changes in the size of neck nodules. Conclusion: NLR has no significant effect on Karnofsky status, on BMI pre- and post-chemotherapy, and neck nodule size pre-chemotherapy. However, NLR had a significant effect on neck nodule size post-chemotherapy and neck nodule size changes.

 

ABSTRAK

Latar belakang: Karsinoma Nasofaring (KNF) merupakan keganasan dalam bidang THT yang menempati urutan ke-4 keganasan di Indonesia. Prognosis pasien KNF terutama ditentukan dari stadium klinis berdasarkan sistem klasifikasi Tumor, Nodul, Metastasis (TNM) yang tidak sepenuhnya dapat diandalkan untuk memprediksi hasil pengobatan. Sedangkan Ratio Netrofil-Limfosit (RNL) mempresentasikan indeks aktivitas protumor dan antitumor sehingga dapat digunakan sebagai pelengkap stadium klinis untuk memprediksi hasil kemoterapi neoadjuvan dan kesejahteraan subjek melalui status Karnofsky, Index Massa Tubuh (IMT) dan ukuran nodul leher. Tujuan: Mempelajari efek Rasio Netrofil-Limfosit (RNL), Index Massa Tubuh (IMT), dan ukuran nodul leher pada subjek dengan KNF WHO tipe III yang telah menjalani 3 siklus kemoterapi neoadjuvan. Metode: Penelitian observasional analitik dengan pendekatan kohort-retrospektif menggunakan data rekam medis penderita KNF tipe III WHO yang menjalani kemoterapi neoadjuvan menggunakan regimen berbasis platinum. RNL sebelum kemoterapi dianalisis pengaruhnya terhadap status Karnofsky, IMT dan ukuran nodul leher. Hasil: RNL berpengaruh tidak signifikan terhadap status Karnofsky sebelum dan sesudah kemoterapi, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, perubahan status Karnofsky, perubahan IMT, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher. Kesimpulan: RNL berpengaruh tidak signifikan terhadap status Karnofsky, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher.


Keywords


nasopharyngeal carcinoma, Neutrophil Lymphocyte Ratio, Karnofsky status, Body Mass Index, neck nodule size (NNS)

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