ArticleFrontiers in oncology2026
Higher pre-treatment lymphocyte-to-monocyte ratio predicts better tumor shrinkage after external beam radiotherapy in locally advanced cervical cancer.
Article in Frontiers in 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 tumor shrinkage rate in patients with locally advanced cervical cancer after external beam radiotherapy varies widely, and simple pretreatment predictors are lacking. The lymphocyte-to-monocyte ratio (LMR) is a routine blood marker reflecting inflammatory and immune status; however, its association with short-term radiotherapy response in cervical cancer remains unclear. Methods: We retrospectively enrolled 247 patients with locally advanced cervical cancer who underwent radical external-beam radiotherapy between April 2020 and April 2025. LMR was calculated from pretreatment blood counts, with extreme values winsorized. The primary outcome was the continuous tumor shrinkage rate and the secondary outcome was a marked response (≥70% shrinkage). Multivariable linear and logistic regressions were used to assess the LMR-shrinkage association, adjusting for age, body mass index, International Federation of Gynecology and Obstetrics stage, pretreatment maximum tumor diameter, lymph node metastasis, concurrent chemoradiotherapy, and radiotherapy dose. Subgroup and sensitivity analyses were also performed. Results: In the multivariate analysis, each unit increase in LMR was associated with a 0.018 absolute increase in shrinkage rate (95% confidence interval (CI)], 0.001-0.036; P = 0.0477). The odds ratio for achieving a marked response was 1.117 per unit increase in LMR (95% CI: 1.002-1.356, P = 0.0241). The LMR effect was consistent across subgroups and remained significant after adjusting for nutritional and oxidative stress markers. The restricted cubic splines exhibit linearity (P for nonlinearity = 0.098). Conclusion: A higher pretreatment LMR was independently associated with better tumor shrinkage after external beam radiotherapy in patients with locally advanced cervical cancer. This readily available hematological marker may help identify patients who are likely to benefit from radiotherapy, although prospective validation is warranted.
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