Monocyte-to-lymphocyte ratio as a prognostic indicator in head and neck squamous cell carcinoma treated with radiotherapy

Background: the monocyte-to-lymphocyte ratio (mlr) has been reported as a useful prognosticator in various types of cancers. we studied the usefulness of mlr as a prognosticator for head and neck squamous cell carcinoma (hnscc) in patients with oropharyngeal, hypopharyngeal, and laryngeal cancer who received radical concurrent chemoradiotherapy (crt) or bioradiotherapy (brt). materials and methods: this study included 76 hnscc patients diagnosed between january 2015 and april 2020. we obtained their haematological records within one month before radiotherapy and calculated the mlr. kaplan-meier method and cox proportional hazard model were performed to evaluate the association of mlr with locoregional recurrence-free survival (lrfs), progression-free survival (pfs), and overall survival (os). results: the kaplan–meier survival analysis for mlr showed a significant difference (p = 0.0326) in os. univariate and multivariate analysis revealed that the lower mlr group was associated with better os (hazard ratio [hr] = 0.345, 95 % confidence interval [ci] = 0.124–0.960, p = 0.042 and hr = 0.305, 95% ci = 0.102-0.916, p = 0.034, respectively). multivariate analysis also revealed that n 2-3 was significant independent predictor of lfrs and pfs (hr = 4.47, 95% ci = 1.43–14.0, p = 0.0286 and hr = 4.94, 95% ci = 1.84-13.2, p < 0.01, respectively). conclusion: mlr was useful as a prognostic predictor for os in patients with hnscc who received radical concurrent crt or brt. mlr may be more reflective of os than of lrfs or pfs.