Neutrophil (N), lymphocyte (L) and platelet (P) are immune cells that modulate inflammatory response. The balance between this cells makes three inflammation indexes reported to be prognostic and predictive factors in several solid tumors. We aimed to investigate the association of Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) with overall survival (OS) and the response to treatment in head and neck squamous cell carcinoma (HNSCC). Were enrolled 427 newly diagnosed HNSCC patients treated with nimotuzumab (group 1) or radiotherapy (group 2). Based on the data obtained before treatment, NLR (NLR = N/L), PLR (PLR = P/L) and SII (SII = N x P/L) were calculated. The cutoff value for every index was determined using the Package ‘bhm’ in R 3.5.0 software. Kaplan–Meier method were used to analyze the association of three indexes with OS and the response to treatment. All statistical analyses were carried out using SPSS version 25 software. Differences were considered statistically significant when p <0.05. Higher NLR, PLR and SII correlated significantly with poorer OS (p = 0.002; p = 0.001; p = 0.000 respectively) in nimotuzumab treated patients. Patients with low inflammation index before treatment who were subsequently treated with nimotuzumab had a longer survival advantage than those in the group treated with radiotherapy. The pretreatment NLR, PLR and SII are promising biomarkers associated with survival of patients with HNSCC and the response to nimotuzumab treatment. It may help to identify the high-risk patients for treatment strategy decisions.

Lisania Reyes has completed her medical specialty in Immunology at the age of 28 and is currently studying for a master's degree in basic immunology at the Victoria de Giron Institute of Basic and Preclinical Sciences, Havana, Cuba. She is a clinical researcher at the center of Molecular Immunology, and an adjunct professor at the Havana University of Medical Sciences, Cuba. She has 5 publications that have been cited over 20 times.