Sustaining Blood Lymphocyte Count during Preoperative Chemoradiotherapy as a Predictive Marker for Pathologic Complete Response in Locally Advanced Rectal Cancer.
- Author:
Jaesung HEO
1
;
Mison CHUN
;
O Kyu NOH
;
Young Taek OH
;
Kwang Wook SUH
;
Jun Eun PARK
;
Oyeon CHO
Author Information
- Publication Type:Original Article
- Keywords: Chemoradiotherapy; Rectal neoplasms; Neoadjuvant therapy; Lymphocyte count; Pathologic complete response; Predictive factor
- MeSH: Blood Cell Count; Carcinoembryonic Antigen; Chemoradiotherapy*; Drug Therapy; Humans; Leukocyte Count; Lymphocyte Count*; Lymphocytes*; Multivariate Analysis; Neoadjuvant Therapy; Odds Ratio; Polymerase Chain Reaction; Radiotherapy; Rectal Neoplasms*
- From:Cancer Research and Treatment 2016;48(1):232-239
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The objective of this study was to explore the relationship between the circulating lymphocyte level during preoperative chemoradiotherapy (CRT) and pathologic complete response (pCR) in locally advanced rectal cancer. MATERIALS AND METHODS: From May 2010 to May 2013, 52 patients treated with preoperative CRT followed by surgery, were analysed. Patients received conventional fractionated radiotherapy (50-54 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. Absolute blood lymphocyte counts and their relative percentage in total white blood cell counts were obtained from complete blood count tests performed prior to and after 4, 8, and 12 weeks of CRT. We analysed the association between achieving pCR and change in blood lymphocyte level during CRT, as well as clinical parameters. RESULTS: Among 52 patients, 14 (26.9%) had evidence of pCR. Sustaining the blood lymphocyte count during CRT (lymphocyte count at 4 weeks/baseline lymphocyte count > 0.35; odds ratio, 8.33; p=0.02) and initial carcinoembryonic antigen < 4.4 ng/mL (odds ratio, 6.71; p=0.03) were significantly associated with pCR in multivariate analyses. CONCLUSION: Sustaining blood lymphocyte count during preoperative CRT was predictive for pCR in rectal cancer. Further studies are warranted to investigate the association between pathologic responses and circulating lymphocyte count with its subpopulation during preoperative CRT.
