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Strahlenther Onkol (2016) 192:632640
http://crossmark.crossref.org/dialog/?doi=10.1007/s00066-016-0988-6&domain=pdf
Web End = DOI 10.1007/s00066-016-0988-6
ORIGINAL ARTICLE
Neoadjuvant chemoradiotherapy of rectal carcinoma
Baseline hematologic parameters inuencing outcomes
Miroslav Hodek1 Igor Sirk1 Alexander Ferko2 Jlius rhalmi2 Eva Hovorkov3 Dimitar Hadi
Nikolov3 Petr Paluska1 Jindich Kopeck1 Ji Petera1 Milan Vomik1
Received: 27 January 2016 / Accepted: 26 April 2016 / Published online: 6 June 2016 Springer-Verlag Berlin Heidelberg 2016
Thus, this study aims to systematically evaluate the relationship between baseline blood count levels and treatment response in rectal cancer patients treated with neoadjuvant chemoradiotherapy.
Patients and methods From 20092015, 173 patients with locally advanced rectal cancer were retrospectively enrolled in the study and analyzed. The baseline blood count was recorded in all patients 1 week before chemoradiation. Tumor response was evaluated through pathologic ndings. Blood count levels which included RBC (red blood cells), Hb (hemoglobin), PLT (platelet count), neutrophil count, WBC (white blood cells), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio) were analyzed in relation to tumor downstaging, pCR (pathologic complete response), OS (overall survival), and DFS (disease-free survival).
Results Hb levels were associated with a response in logistic regression analysis: pCR (p = 0.05; OR 1.04, 95 % CI1.001.07); T downstaging (p = 0.006; OR 1.03, 95 % CI1.011.05); N downstaging (p = 0.09; OR 1.02, 95 % CI1.001.04); T or N downstaging (p = 0.007; OR 1.04, 95 % CI 1.011.07); T and N downstaging (p = 0.02; OR 1.02, 95 % CI 1.001.04); Hb and RBC were the most signicant parameters inuencing OS; PLT was a negative prognostic factor for OS and DFS (p = 0.008 for OS); an NLR value of 2.8 was associated with the greatest significance for OS (p = 0.03) and primary tumor downstaging (p = 0.02).
Conclusion Knowledge of pretreatment hematological parameters appears to be an important prognostic factor in patients with rectal carcinoma.
Keywords Hemoglobin level Blood platelets Neoadjuvant Treatment Neutrophil-to-lymphocyte ratio Tumor regression
Abstract
Background The link between the blood count and a systemic inammatory response (SIR) is indisputable and well described. Pretreatment hematological parameters may predict the overall clinical outcomes in many types of cancer.
[envelopeback] Miroslav Hodek, M.D. [email protected]
Igor Sirk, M.D., Ph.D. [email protected]
Prof. Alexander Ferko, M.D., Ph.D. [email protected]
Jlius rhalmi, M.D. [email protected]
Eva Hovorkov, M.D. [email protected]
Dimitar...