PMID- 31569166
OWN - NLM
STAT- MEDLINE
DCOM- 20200323
LR  - 20200323
IS  - 1537-453X (Electronic)
IS  - 0277-3732 (Linking)
VI  - 42
IP  - 12
DP  - 2019 Dec
TI  - The Prognostic Role of Pretreatment Neutrophil to Lymphocyte Ratio (NLR) in 
      Malignant Adrenal Lesions Treated With Stereotactic Body Radiation Therapy 
      (SBRT).
PG  - 945-950
LID - 10.1097/COC.0000000000000610 [doi]
AB  - OBJECTIVE: The objective of this study was to evaluate a single institution's 
      experience with stereotactic body radiotherapy (SBRT) in treating malignant 
      adrenal lesions, as well as the prognostic value of systemic inflammation 
      biomarkers. MATERIALS AND METHODS: From November 2007 to February 2018, 27 
      patients with malignant adrenal lesions received 31 SBRT treatments. Outcomes, 
      measured from the date of SBRT, included overall survival (OS), local control 
      (LC), and freedom from progression. Cox proportional hazard model was utilized to 
      identify potential prognostic factors. Tumor response was assessed with PET 
      Response Evaluation Criteria In Solid Tumors (PERCIST)/Response Evaluation 
      Criteria in Solid Tumors (RECIST) criteria. Acute toxicity was evaluated with the 
      National Cancer Institute Common Terminology Criteria for Adverse Events, version 
      4.03 criteria. RESULTS: Median follow-up for all patients was 8 months. The 
      complete response, partial response, stable disease, and progressive disease 
      rates were 59%, 9%, 32%, and 0%, respectively. One-year LC, OS, and freedom from 
      progression were 77.7%, 38.0%, and 10.0%, respectively. There was a trend toward 
      significance upon multivariate analysis for pretreatment neutrophil to lymphocyte 
      ratio >4.1 to predict inferior OS (adjusted hazard ratio=3.29, P=0.09, 1-year OS: 
      11% vs. 80%). There were 3 cases (10%) complicated by grade 2 acute toxicity, 
      including nausea and fatigue. There was 1 grade 5 toxicity, as 1 case was 
      complicated by a fatal gastric ulcer occurring 3 months after SBRT to the left 
      adrenal gland (112.5 BED10). CONCLUSIONS: These results support the limited 
      existing literature, demonstrating that SBRT provides adequate LC for adrenal 
      lesions with minimal toxicity. Pretreatment neutrophil to lymphocyte ratio may 
      serve as a prognostic factor in these patients.
FAU - Mills, Matthew N
AU  - Mills MN
AD  - Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research 
      Institute, Tampa, FL.
FAU - Reddy, Abhinav V
AU  - Reddy AV
AD  - Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins 
      Medicine, Baltimore, MD.
FAU - Richardson, Logan
AU  - Richardson L
AD  - Department of Radiation Oncology, Riverside Regional Medical Center, Newport 
      News, VA.
FAU - Richardson, K Martin
AU  - Richardson KM
AD  - Department of Radiation Oncology, Riverside Regional Medical Center, Newport 
      News, VA.
FAU - Kersh, Charles R
AU  - Kersh CR
AD  - Department of Radiation Oncology, Riverside Regional Medical Center, Newport 
      News, VA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Clin Oncol
JT  - American journal of clinical oncology
JID - 8207754
RN  - 0 (Biomarkers, Tumor)
SB  - IM
MH  - Adrenal Gland Neoplasms/mortality/*secondary/*surgery
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/*blood
MH  - Cohort Studies
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Lymphocytes/*cytology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoplasm Invasiveness/pathology
MH  - Neoplasm Staging
MH  - Neutrophils/*cytology
MH  - Preoperative Care/methods
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Radiosurgery/*methods/mortality
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - United States
EDAT- 2019/10/01 06:00
MHDA- 2020/03/24 06:00
CRDT- 2019/10/01 06:00
PHST- 2019/10/01 06:00 [pubmed]
PHST- 2020/03/24 06:00 [medline]
PHST- 2019/10/01 06:00 [entrez]
AID - 10.1097/COC.0000000000000610 [doi]
PST - ppublish
SO  - Am J Clin Oncol. 2019 Dec;42(12):945-950. doi: 10.1097/COC.0000000000000610.