ArticleFrontiers in oncology2026
Association of dynamic changes in platelet-to-lymphocyte ratio during chemotherapy with survival in patients with non-small cell lung 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: Inflammatory markers have been reported to be associated with outcomes in non-small cell lung cancer (NSCLC). However, whether early treatment-related changes in these markers provide additional prognostic information remains unclear. This study evaluated the association between dynamic changes in peripheral blood inflammatory markers during chemotherapy and survival outcomes in patients with NSCLC. Methods: We retrospectively analyzed 479 patients with NSCLC who received chemotherapy. Changes in lymphocyte, platelet, and neutrophil counts, as well as the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR), were calculated as absolute differences (D-values) between baseline measurements obtained before the first chemotherapy session and post-chemotherapy measurements obtained within 7 days after the first session. Overall survival (OS) was assessed using Kaplan-Meier analysis and Cox proportional hazards models. Additional Cox models were used to examine the association of PLR D-value with OS after accounting for baseline PLR and clinical covariates. A prognostic nomogram was constructed as an exploratory risk-estimation model. Results: Greater changes in the evaluated hematological markers were associated with shorter OS in Kaplan-Meier analysis. In the primary multivariable Cox regression, high PLR D-value was associated with shorter OS (hazard ratio, 1.422; 95% confidence interval, 1.001-2.020; Conclusions: Greater changes in PLR during chemotherapy were associated with shorter OS in the primary categorical analysis. However, this association was attenuated after baseline PLR and clinical factors were taken into account, indicating that the additional prognostic contribution of PLR D-value may be limited. The nomogram should be considered exploratory and requires external validation before clinical application.
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