P05.11.A DYNAMIC MONITORING OF INFLAMMATORY SCORES IN GLIOBLASTOMA: IMPLICATIONS FOR PROGNOSIS AND TUMOR MICROENVIRONMENT

Abstract BACKGROUND The use of inflammatory scores has become widespread in the prognostic assessment of inflammatory diseases and certain cancers. In glioblastoma, their application has mainly focused on the time of diagnosis, with little exploration of their dynamics throughout the disease course. The aim of the present work is to analyze the evolution of inflammatory scores during different stages of glioblastoma, their association with initial radiological features, and their prognostic value. MATERIAL AND METHODS We included 43 patients with IDH-wildtype glioblastoma diagnosed between 2016 and 2023, who underwent complete resection and completed radiochemotherapy. Four inflammatory scores the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Monocyte-to-Lymphocyte Ratio (MLR), and the Systemic Inflammatory Response Index (SIRI) were calculated at three timepoints: diagnosis, post-radiochemotherapy, and progression. Tumor volumes were segmented from preoperative MRI using Oncohabitats®. Temporal changes and associations with survival were analyzed using nonparametric tests, Pearson correlations, Kaplan-Meier curves, and Cox regression. RESULTS PLR and SIRI remained stable throughout the disease course. NLR significantly decreased after radiochemotherapy (5.26 vs. 3.81; p<0.05), while MLR increased (0.30 vs. 0.42; p<0.05). At progression, NLR was lower than at diagnosis (3.65 vs. 5.26; p<0.05) and MLR was higher (0.45 vs. 0.30; p<0.001). NLR correlated positively with edema volume (r=0.556; p=0.001), contrast enhancement (r=0.390; p=0.0027), and necrosis (r=0.562; p=0.001). PLR also correlated positively with these volumes, while SIRI correlated with contrast enhancement (r=0.483; p=0.005). MLR showed no significant correlations. High NLR and SIRI levels at progression were associated with worse overall survival (NLR: HR=2.059, p=0.044; SIRI: HR=2.315, p=0.017). CONCLUSION Changes in NLR and MLR across disease stages may reflect biological responses to treatment and tumor progression. The positive correlations between inflammatory scores and tumor volumes suggest that these scores may reflect the tumor microenvironment status and its systemic impact. Furthermore, elevated NLR and SIRI at progression are associated with worse prognosis, supporting the clinical relevance of their dynamic monitoring.