Radiotherapy-induced high neutrophil-to-lymphocyte ratio is a negative prognostic factor in patients with breast cancer

Chang Ik Yoon, Dooreh Kim, Sung Gwe Ahn, Soong June Bae, Chihwan Cha, Soeun Park, Seho Park, Seung Il Kim, Hye Sun Lee, Ju Young Park, Joon Jeong

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Radiotherapy (RT) is the standard of care following breast-conserving operation in breast cancer patients. The neutrophil-to-lymphocyte ratio (NLR) reflects the systemic change caused as a result of the radiotherapy. We aimed to evaluate the association between RT and the change in NLR following the receipt of RT, and to investigate the prognostic impact. We retrospectively reviewed NLR values of breast cancer patients taken before the administration of the first and the last session of RT. The cut-off point for the NLR was determined using the Youden index and receiver operating characteristic (ROC) curve within the training set. Recurrence-free survival (RFS), distant metastasis free survival, and overall survival were the main outcomes. Patients with an NLR higher than 3.49 after RT were classified to an RT-induced high NLR group and showed a significantly higher recurrence rate compared to those with low NLR (p < 0.001). In a multivariate Cox proportional hazards model, RT-induced high NLR remained a significant prognostic factor (HR 2.194, 95% CI 1.230–3.912, p = 0.008 for tumor recurrence. We demonstrated that an increase in NLR over the course of RT has a negative impact on survival, putting these patients with RT-susceptible host immunity at a higher risk of tumor recurrence.

Original languageEnglish
Article number1896
Pages (from-to)1-12
Number of pages12
Issue number7
Publication statusPublished - 2020 Jul

Bibliographical note

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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