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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1469191
A nomogram incorporating the pretreatment peripheral blood neutrophil-to-lymphocyte ratio predicts survival in patients with nasopharyngeal carcinoma
Provisionally accepted- 1Jiangxi Cancer Hospital, Nanchang, China
- 2Department of Oncology, Huanggang Central Hospital, Huanggang, China
- 3The Affiliated Hospital of Southwest Medical University, Luzhou, China
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AbstractBackground This study was performed to investigate the relationship of the pretreatment neutrophil count and neutrophil-to-lymphocyte ratio (NLR) with the prognosis of nasopharyngeal carcinoma (NPC), as well as to establish an NLR-related nomogram to predict survival in patients with NPC.Methods In total, 747 patients with NPC were enrolled between January 2005 and January 2015 at our hospital. Kaplan–Meier survival analysis was used to evaluate overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS), with comparisons made using the log-rank test. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors for OS, PFS, and DMFS. The optimal NLR cut-off value was determined using receiver operating characteristic curve analysis. A nomogram model was then constructed and validated using R software (Version 3.6.0).Results Among the 747 patients, N stage (P = 0.01, 0.042, 0.017) and NLR (P = 0.037) were identified as independent predictors of DMFS. Independent predictors of OS were sex (P = 0.024), age (P = 0.019), N stage (P = 0.006, 0.031, 0.002), American Joint Committee on Cancer (AJCC) stage (P = 0.003), adjuvant chemotherapy (P = 0.016), and NLR (P = 0.036). N stage (P = 0.001, 0.0221, 0.003), AJCC stage (P = 0.001), and NLR (P = 0.035) were also associated with PFS. The prognostic model showed good agreement with actual outcomes. Compared with the TNM staging system, the nomogram demonstrated superior accuracy and stability.Conclusions In patients with NPC, an elevated pretreatment NLR was associated with poorer OS, PFS, and DMFS. The NLR-based nomogram provided more accurate survival prediction than clinical staging and may serve as a valuable tool in guiding prognosis and treatment planning.
Keywords: nasopharyngeal carcinoma, Neutrophil-to-lymphocyte ratio, overall survival, prognostic factors, Nomograms
Received: 31 Jul 2024; Accepted: 16 Apr 2025.
Copyright: © 2025 Zhang, Feng, Pang, Yu, Lu, Li, Xu and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chunling Jiang, Jiangxi Cancer Hospital, Nanchang, China
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