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Abstract Objective To investigate the relationship between platelet to lymphocyte ratio (PLR) and prognosis in patients with small cell lung cancer (SCLC). Methods Clinical data， including platelet and lymphocyte counts， of 165 patients with SCLC admitted to our hospital from June 2008 to June 2018 were collected and retrospectively analyzed and their survival were followed up. The optimal cut-off value of PLR was determined with time-dependent receiver operating curve (ROC curve) analysis in SPSS 22.0 statistical software. The overall survival (OS) and progression-free survival (PFS) of high PLR and low PLR groups were evaluated with Kaplan-Meier analysis respectively and Multivariate Cox regression models were applied to evaluate the independent prognostic significance of PLR. Results ROC curve analysis showed that PLR ＝ 189 was optimal cut-off value. One hundred and twenty cases were found in the low PLR (<189) group and 45 cases fell in the high PLR (≥189) group. The progression-free survival of patients with low PLR was higher than that of high PLR (8.6 months vs 6 months， P=0.016). The overall survival of patients with low PLR was higher than that of high PLR (13.8 months vs 12.1 months， P= 0.016). COX multivariate regression analysis showed that radiotherapy can be used as an independent prognostic factor for both PFS and OS in patients with SCLC(HR=0.488， 95%CI=0.303~0.787， P=0.003； HR=0.314， 95%CI=0.190~0.519， P=0.000. PLR level can be used as an independent prognostic factor for PFS in patients with SCLC (HR=1.538， 95%CI=1.040~2.274， P=0.031)， but not as an independent prognostic factor for OS (HR=1.323， 95%CI=0.883~1.982， P=0.175). Conclusion PLR can reflect the prognosis of patients with SCLC， but it cannot be used as an independent prognostic factor.
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