{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T04:31:48Z","timestamp":1793421108302,"version":"4.5.0"},"reference-count":37,"publisher":"Radiation Research Society","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiation Research"],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<jats:p>Laryngeal squamous cell carcinoma (SQCC), in both early and advanced stages, is often treated non-surgically with definitive-intent radiotherapy or chemoradiotherapy. In advanced-stage disease, uninvolved lymphatic structures of the neck are electively irradiated, whereas in early-stage disease the larynx alone is irradiated. The neutrophil-to-lymphocyte ratio (NLR) has been implicated as a prognostic marker in head and neck SQCC. As lymphocytes are extremely radiosensitive, the absolute lymphocyte count (ALC) may fluctuate during and after radiotherapy, and consequently, the NLR may vary across these time points. This study aimed to evaluate dynamic changes in NLR, ALC, and absolute neutrophil count (ANC) during and after radiotherapy and to assess their association with oncologic outcomes in patients with laryngeal SQCC. We retrospectively reviewed the charts of patients treated with definitive-intent radiotherapy or chemoradiotherapy for laryngeal carcinoma at our institution between 2015 and 2021. NLR, ANC, and ALC values were recorded at three time points: treatment initiation, treatment completion, and three to six months after treatment completion. Oncologic outcomes were also recorded. A total of 174 patients treated for laryngeal SQCC were included. The mean NLR level was significantly higher at treatment completion than at treatment initiation (6.23 \u00b1 4.61 vs. 3.12 \u00b1 3.32, P &lt; 0.001) and was significantly lower at 3-6 months after treatment than at treatment completion (3.75 \u00b1 2.15 vs. 6.23 \u00b1 4.61, P &lt; 0.001). An NLR level above 4 at treatment completion was associated with worse overall survival (log-rank P = 0.005). NLR above 4 at treatment completion and 3-6 months afterward was associated with worse disease-free survival (log-rank P = 0.047 and P = 0.011, respectively). Mean ALC declined from 1.91 \u00b1 0.70 3 103\/\u00b5L at baseline to 0.90 \u00b1 0.51 3 103\/\u00b5L at treatment completion and partially recovered to 1.36 \u00b1 0.52 3 103\/\u00b5L at follow-up, whereas ANC remained relatively stable (4.95 \u00b1 1.70, 4.38 \u00b1 1.99, and 4.38 \u00b1 1.44 3 103\/\u00b5L, respectively). NLR significantly increases during oncologic treatment. Our study demonstrates a novel association between NLR at the end of treatment for laryngeal SQCC and survival. Patients whose NLR remains high 3\u20136 months after treatment experience worse disease-free survival. The transient rise in NLR appears to be largely driven by radiation-induced lymphocyte depletion. These findings support routine monitoring of both NLR and ALC in patients undergoing radiotherapy for laryngeal cancer.<\/jats:p>","DOI":"10.1667\/rade-25-00039.1","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:38:03Z","timestamp":1785497883000},"page":"376-384","source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil-to-Lymphocyte Ratio in Laryngeal SQCC Treated by Radiotherapy: Prognostic and Predictive Value"],"prefix":"10.1667","volume":"206","author":[{"given":"Noam","family":"Koch","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Yosefof","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofir","family":"Zavdy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Tzelnick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Hamzany","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Popovtzer","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noga","family":"Kurman","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1243","reference":[{"key":"17","doi-asserted-by":"crossref","unstructured":"Z Mei, L Shi, B Wang, et al.  \"Cancer Treat Rev.\"  58, \"Prognostic role of pretreatment blood neutrophil-to-lymphocyte ratio in advanced cancer survivors: a systematic review and meta-analysis of 66 cohort studies.\" 1 (2017)","DOI":"10.1016\/j.ctrv.2017.05.005"},{"key":"1","doi-asserted-by":"publisher","unstructured":"C Fitzmaurice, D Abate, N Abbasi, et al.  \"JAMA Oncol.\"  5, \"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017.\" 1749 (2019)","DOI":"10.1001\/jamaoncol.2019.2996"},{"key":"2","doi-asserted-by":"publisher","unstructured":"EA Chu  and YJ Kim  \"Otolaryngolog Clin North Am.\"  41, \"Laryngeal cancer: Diagnosis and preoperative work-up.\" 673 (2008)","DOI":"10.1016\/j.otc.2008.01.016"},{"key":"3","doi-asserted-by":"publisher","unstructured":"VJ Schorn  and BA Miles  \"Springer eBooks.\"  \"Laryngeal Squamous Cell Carcinoma.\" 227 (2013)","DOI":"10.1007\/978-1-4614-8354-0_20"},{"key":"4","doi-asserted-by":"publisher","unstructured":"A. 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\"Front Oncol2022.\"  12, \"Prognostic value of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in laryngeal cancer: What should we expect from a meta-analysis?\" 945820","DOI":"10.3389\/fonc.2022.945820"},{"key":"37","doi-asserted-by":"publisher","unstructured":"Jean-Pascal Machiels, Y Tao, L Licitra, et al.  \"Lancet Oncol.\"  25, \"Pembrolizumab plus concurrent chemoradiotherapy versus placebo plus concurrent chemoradiotherapy in patients with locally advanced squamous cell carcinoma of the head and neck (KEYNOTE-412): a randomised, double-blind, phase 3 trial.\" 572 (2024)","DOI":"10.1016\/s1470-2045(24)00100-1"},{"key":"19","doi-asserted-by":"crossref","unstructured":"H Gonzalez, C Hagerling, Z Werb,  \"Genes Dev.\"  32, \"Roles of the immune system in cancer: From tumor initiation to metastatic progression.\" 1267 (2018)","DOI":"10.1101\/gad.314617.118"}],"container-title":["Radiation Research"],"original-title":[],"link":[{"URL":"https:\/\/radiation-research.kglmeridian.com\/view\/journals\/rare\/aop\/article-10.1667-RADE-25-00039.1\/article-10.1667-RADE-25-00039.1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/radiation-research.kglmeridian.com\/downloadpdf\/journals\/rare\/aop\/article-10.1667-RADE-25-00039.1\/article-10.1667-RADE-25-00039.1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T04:14:46Z","timestamp":1793420086000},"score":1,"resource":{"primary":{"URL":"https:\/\/bioone.org\/journals\/radiation-research\/volume-206\/issue-4\/RADE-25-00039.1\/Neutrophil-to-Lymphocyte-Ratio-in-Laryngeal-SQCC-Treated-by-Radiotherapy\/10.1667\/RADE-25-00039.1.full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1667\/rade-25-00039.1","relation":{},"ISSN":["0033-7587","1938-5404"],"issn-type":[{"value":"0033-7587","type":"print"},{"value":"1938-5404","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]}}}