Abstract: Objective To investigate the relationship between neutrophils to lymphocytes ratio（NLR） and concurrent chemotherapy（CCRT） and prognosis in elderly patients with advanced cervical squamous cell carcinoma. Methods A retrospective analysis was performed in 103 elderly patients with advanced cervical squamous cell carcinoma（stage Ⅱ B-ⅢB） who underwent CCRT in Qingdao Central Hospital from January 2014 to December 2018. The patients were divided into high NLR group（NLR≥3.48） and low NLR group（NLR＜3.48）. The efficacy of CCRT between the two groups were compared，and the factors affecting prognosis were analyzed. Results The clinical efficacy of the high NLR group was statistically significantly lower than that of the low NLR group（57.69% vs 84.31%，χ²=8.840，P=0.004）. NLR was not related to age，size of tumor and degree of histological differentiation（P>0.05），but related to FIGO stage and lymph node metastasis（P<0.05）. The median OS of the high NLR group was lower than that of the low NLR group （24.0 months vs 46.0 months，χ²=7.187，P=0.007）. Multivariate Cox regression analysis showed that NLR≥3.48 was an independent risk factor for OS in elderly patients with advanced cervical squamous cell carcinoma（HR=1.937，95%CI：1.086-3.456，P=0.025）. Conclusions In elderly patients with advanced cervical squamous cell carcinoma with high NLR values before treatment, concurrent chemoradiotherapy is less effective，which is suggested a poor prognosis.

Key words: Cervical squamous cell carcinoma, Neutrophils to lymphocytes ratio, Elderly patient, Prognosis