The aspartate aminotransaminase/alanine aminotransaminase (De Ritis) ratio predicts sensitivity to radiotherapy in head and neck carcinoma patients

Head Neck. 2021 Jul;43(7):2091-2100. doi: 10.1002/hed.26673. Epub 2021 Mar 6.

Abstract

Background: The aim of this study is to evaluate the relationship between the aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT) ratio and local disease control in patients with head and neck squamous cell carcinomas (HNSCC) treated with radiotherapy/chemoradiotherapy.

Methods: We calculated the pre-treatment AST/ALT ratio in 670 patients with HNSCC treated with radiotherapy (n = 309, 46.1%) or chemoradiotherapy (n = 361, 53.9%).

Results: Five-year local recurrence-free survival for patients with a low AST/ALT ratio value (n = 529, 79.0%) was 75.0% (95% CI: 71.1-78.9), and for patients with a high value (n = 141, 21.0%) it was 53.4% (CI 95: 44.4-62.4) (p = 0.0001). In a multivariable analysis, patients with a high ratio had nearly twice the risk of having a local tumor recurrence (HR 1.97, 95% CI 1.42-2.75, p = 0.0001).

Conclusion: The AST/ALT ratio was independently associated with the risk of local recurrence in patients with HNSCC treated with radiotherapy or chemoradiotherapy.

Keywords: AST/ALT (DeRitis) ratio; alanine aminotransaminase; aspartate aminotransaminase; prognostic factor; radiotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alanine
  • Alanine Transaminase
  • Aspartate Aminotransferases
  • Aspartic Acid
  • Biomarkers, Tumor
  • Carcinoma*
  • Head and Neck Neoplasms* / radiotherapy
  • Humans
  • Neoplasm Recurrence, Local
  • Prognosis
  • Retrospective Studies

Substances

  • Biomarkers, Tumor
  • Aspartic Acid
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Alanine