TY  - JOUR
A1  - Frey, Alina Maria
A1  - Martin, Daniel
A1  - D'Cruz, Louisa
A1  - Fokas, Emmanouil
A1  - Rödel, Claus
A1  - Fleischmann, Maximilian
T1  - C-reactive protein to albumin ratio as prognostic marker in locally advanced non-small cell lung cancer treated with chemoradiotherapy
T2  - Biomedicines
N2  - Despite the implementation of consolidative immune checkpoint inhibition after definitive chemoradiotherapy (CRT), the prognosis for locally advanced non-small-cell lung cancer (NSCLC) remains poor. We assessed the impact of the C-reactive protein (CRP) to albumin ratio (CAR) as an inflammation-based prognostic score in patients with locally advanced NSCLC treated with CRT. We retrospectively identified and analyzed 52 patients with primary unresectable NSCLC (UICC Stage III) treated with definitive/neoadjuvant CRT between 2014 and 2019. CAR was calculated by dividing baseline CRP by baseline albumin levels and correlated with clinicopathologic parameters to evaluate prognostic impact. After dichotomizing patients by the median, univariate and multivariate Cox regression analyses were performed. An increased CAR was associated with advanced T-stage (p = 0.018) and poor performance status (p = 0.004). Patients with pre-therapeutic elevated CAR had significantly lower hemoglobin and higher leukocyte levels (hemoglobin p = 0.001, leukocytes p = 0.018). High baseline CAR was shown to be associated with worse local control (LPFS, p = 0.006), shorter progression-free survival (PFS, p = 0.038) and overall survival (OS, p = 0.022), but not distant metastasis-free survival (DMFS). Multivariate analysis confirmed an impaired outcome in patients with high CAR (LPFS: HR 3.562, 95% CI 1.294–9.802, p = 0.011). CAR is an easily available and independent prognostic marker after CRT in locally advanced NSCLC. CAR may be a useful biomarker for patient stratification to individualize treatment concepts.
KW  - C-reactive protein
KW  - CAR
KW  - CRT
KW  - NSCLC
KW  - albumin
KW  - biomarker
KW  - chemoradiotherapy
KW  - inflammation
KW  - predictive
KW  - prognostic
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/82382
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-823828
SN  - 2227-9059
VL  - 10
IS  - 3, art. 598
SP  - 1
EP  - 12
PB  - MDPI
CY  - Basel
ER  -