Abstract

Patients with triple-negative breast cancer experience high rates of recurrence following radiation, which may be facilitated by the recruitment of circulating tumor cells to pro-inflammatory microenvironments in the absence of lymphocytes. We hypothesized that patients with lymphopenia and elevated inflammatory hematologic markers after radiotherapy would have an increased risk of locoregional failure.With approval, we retrospectively studied a cohort of women treated with adjuvant radiotherapy for stage II-III triple-negative breast cancer. We analyzed the relationship between post-radiotherapy neutrophil:lymphocyte ratio (NLR) and locoregional recurrence by Cox regression.130 patients met inclusion criteria, and median follow up time was 7.6 years. Patients with an NLR = 3 had a higher rate of locoregional failure (p=0.04) and lower overall survival (p=0.04). After adjusting for stage (HR = 5.5, p < 0.0001) and neoadjuvant chemotherapy (HR = 2.5, p = 0.0162), NLR was highly predictive of locoregional failure, (HR = 1.4, p = 0.0009). NLR was also highly predictive of overall survival (HR = 1.3, p = 0.0007) after adjustment for stage and neoadjuvant chemotherapy.Innate peripheral inflammation following radiotherapy for triple-negative breast cancer in an immunocompromised setting may be a novel prognostic biomarker for locoregional recurrence, progression, and survival. This finding supports preclinical studies of post-radiotherapy inflammation-mediated tumor progression. Further studies are needed to confirm this finding and develop treatment strategies.

View details for DOI 10.1016/j.ijrobp.2019.11.398

View details for PubMedID 31809877