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http://dx.doi.org/10.7314/APJCP.2013.14.6.3881

Circulating Lymphocytes as Predictors of Sensitivity to Preoperative Chemoradiotherapy in Rectal Cancer Cases  

Dou, Xue (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Wang, Ren-Ben (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Yan, Hong-Jiang (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Jiang, Shu-Mei (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Meng, Xiang-Jiao (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Zhu, Kun-Li (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Xu, Xiao-Qing (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, University of Jinan)
Mu, Dian-Bin (Department of Pathology, Shandong Cancer Hospital and Institute, University of Jinan)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.14, no.6, 2013 , pp. 3881-3885 More about this Journal
Abstract
Objective: The objective of this study was to identify clinical predictive factors for tumor response after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). Methods: All factors were evaluated in 88 patients with LARC treated with nCRT. After a long period of 4-8 weeks of chemoradiotherapy, 3 patients achieved clinical complete response (cCR) and thus aggressive surgery was avoided, and the remaining 85 patients underwent a curative-intent operation. The response to nCRT was evaluated by tumor regression grade (TRG) system. Results: There were 32 patients (36.4%) with good tumor regression (TRG 3-4) and 56 (63.6%) with poor tumor regression (TRG 0-2). Lymphocyte counts and ratios were higher in good response cases (P=0.01, 0.03, respectively) while neutrophil ratios and N/L ratios were higher in poor response cases (P=0.04, 0.02, respectively). High lymphocyte ratios before nCRT and good tumor regression (TRG3-4) were significantly associated with improved 5-year disease-free survival (P<0.05). Pretreatment nodal status was also significantly associated with 5-year disease-free survival and 5-year overall survival (P<0.05). Multivariate analysis confirmed that the pretreatment lymphocyte ratio and lymph nodal status were independent prognostic factors. Conclusion: Our study suggested that LARC patients with high lymphocyte ratios before nCRT would have good tumor response and high 5-year DFS and OS.
Keywords
Rectal cancer; lymphocytes; neoadjuvant chemoradiotherapy; tumor regression grade;
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