Pretreatment Neutrophil-to-Lymphocyte Ratio as a Predictor of Response to Definitive Chemoradiotherapy in Patients with Locally Advanced Cervical Cancer

S M Nazmuz Sakib

doi:10.31557/APJEC.3145.20260919

Authors

S M Nazmuz Sakib Dhaka International University, Satarkul Rd, Dhaka - 1212, Bangladesh. Fellow, Scholars Academic and Scientific Society, H.No-204, Borhawor, P.S-Murajhar, Dist- Hojai, Assam-782439, India. Institute of Medical Technology, Faculty of Medicine, University of Dhaka, Bangladesh. https://orcid.org/0000-0001-9310-3014

DOI:

https://doi.org/10.31557/APJEC.3145.20260919

Keywords:

Neutrophil-lymphocyte ratio, cervical cancer, chemoradiation, treatment response, inflammation, biomarker

Abstract

Objective: To evaluate the role of the neutrophil-to-lymphocyte ratio (NLR) as a predictor of clinical response to chemoradiotherapy in patients with cervical cancer.

Background: Systemic inflammation plays an important role in cancer progression and treatment outcomes. The neutrophil-to-lymphocyte ratio (NLR), an inexpensive marker derived from routine complete blood counts, has demonstrated prognostic value in several malignancies. This study investigated the predictive value of pretreatment NLR for clinical response to chemoradiotherapy in cervical cancer.

Materials and Methods: This observational study included 60 women with histologically confirmed cervical cancer (FIGO stages IB–IVA) who received external beam radiotherapy followed by brachytherapy with concurrent cisplatin-based chemotherapy. Pretreatment NLR was calculated from baseline complete blood counts. Clinical response was assessed three months after completion of treatment. The association between NLR (cut-off value: 2.9) and treatment response was analyzed.

Results: The median patient age was 49 years. Complete clinical response was achieved in 44 patients (73.3%). Among these patients, 75.0% had a pretreatment NLR below 2.9. Although patients with lower NLR tended to have better treatment responses, the association between NLR and clinical response did not reach statistical significance (p = 0.06).

Conclusion: Pretreatment NLR may serve as a simple and cost-effective biomarker for predicting response to chemoradiotherapy in cervical cancer. Although the observed association was not statistically significant, the favorable trend suggests that larger prospective studies with longer.