がんの科学と治療

The Pre-treatment Systemic Inflammatory Response Biomarkers are Important Determinant of Prognosis for Patients Undergoing Neoadjuvant Therapy for Rectal Cancer

Abstract

Hala Zaghloul and Ahmed Abbas

Purpose: This research looks at inflammatory response biomarkers in the context of their prognostic potential, derived neutrophil to lymphocyte ratio (dNLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) in patients suffering from rectal cancer and being administered neoadjuvant chemoradiation preceding surgical resection.

Methods: This work offers a retrospective review of “T3/T4, or N+ rectal cancer receiving neoadjuvant chemoradiation 50.4 Gy concurrently with either 5 FU (1 g/m2/d) or Capecitabine 825 mg/m2 twice daily. Pretreatment NLR, dNLR, PLR and LMR measured with the help of peripheral blood cell counts were correlated to clinicopathological parameters. Baseline NLR, dNLR, PLR and LMR prognostic value for disease free survival (DFS) and overall survival (OS) were studied through Cox regression and Log rank.

Results: This study revolved around 80 participants who had undergone resection subsequent to neoadjuvant chemoradiation. ROC or receiver operating curve cut off values for baseline were NLR (3), dNLR (2.1), LMR (4.9) and PLR(169). “Augmented NLR, dNLR, PLR, LMR , age ≥50 years , depth of invasion ≥T3 , lymph node N1-N2, stage III , grade 3 tumors, and partial response to pre-operative chemo-radiation were significantly correlated to reduced OS and DFS. A multivariate evaluation highlighted that risen NLR and dNLR stood as independent elements for worsened OS with an HR (hazard ratio) of 2.34 (95% CI= 3.41-7.24), 4.53 (95% CI, 2.61-8.32) and poor DSF with HR 1.64 (95% CI= 2.27-5.36), 4.23 (95% CI= 3.49-9.52), respectively.”

Conclusion: The baseline inflammatory prognosticators revealed substantial link to various prognostic clinicpathological parameters in the context of rectal cancer patients who had undergone neoadjuvant chemo-radiation. Moreover, both NLR and dNLR can be seen as possible independent indicators for prognosis in the given patient group.