ArticleReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology2026
Neutrophile-to-lymphocyte ratio predicts survival in patients aged 80 years and older undergoing radiotherapy: a single-center experience.
Article in Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The aging population has increased the incidence of cancer among individuals aged ≥ 80 years, highlighting the need to understand treatment feasibility and prognostic factors in this group. This study evaluated the feasibility and safety of radiotherapy in octogenarians with solid tumors and assessed clinical and laboratory predictors of survival. Materials and methods: A single-center retrospective analysis included patients aged ≥ 80 years treated with radiotherapy between 2021 and 2022, with ≥ 12 months of follow-up. Clinical data, laboratory results, and outcomes were collected from medical records. Cut-off values for the neutrophile-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were determined using time-dependent ROC analysis. Their predictive value for mortality was examined, and multivariate logistic regression identified prognostic factors. Results: A total of 352 patients (median age: 84) were included. Radiotherapy was administered with curative intent in 43.2% and palliatively in 56.8%. Median overall survival was 14.4 months, and 30-day mortality was 7.1%. An NLR cut-off of 3.64 strongly predicted 30-day mortality, while PLR showed weaker association. Poor performance status, NLR > 3.64, and living with family were linked to shorter survival. In curative cases, low NLR did not significantly improve survival, whereas in the palliative subgroup it was associated with longer survival. Radiotherapy was well tolerated, with grade ≥ 3 adverse events in 4.8% of patients. Conclusions: Radiotherapy is feasible and generally well tolerated in octogenarians. NLR appears to be a simple, cost-effective biomarker supporting pre-treatment assessment. Prospective validation is needed.
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