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DOI: 10.1016/j.jcol.2015.01.003
Analysis of neutrophil–lymphocyte ratio as a prognostic element in the response to neoadjuvant therapy in rectal cancer
Análise da relação neutrófilo-linfócito como elemento prognóstico na resposta à terapia neo-adjuvante no câncer do reto
Abstract
Introduction The previous radio-chemotherapy approach is highly relevant in the management of rectal cancer, collaborating on organ functional preservation, being performed prior to surgery. The inflammatory response plays an important role in this treatment.
Objective It consists in correlating the number of peripheral lymphocytes and the neutrophil/lymphocyte ratio in the peripheral blood with tumor response to neoadjuvant therapy.
Methods Review of medical records of patients with rectal cancer in HMSJ and HSJ Oncology Services since 2009 – cases submitted to neoadjuvant treatment with radio-chemotherapy.
Results Of those 96 patients with this disease who underwent neoadjuvant therapy with radio-chemotherapy, 35 patients were eligible; complete tumor response was observed in 11 cases (31%), and 9 were submitted to surgical treatment. Comparing the leukocyte parameters between patients with complete response (CR) and incomplete response (IR) the following values were observed: total number of leukocytes (mean) CR 7390.9 × IR 7220.4 (p = 0.8); total lymphocytes CR 2103 × IR 1960.9 (p = 0.4); neutrophil/lymphocyte ratio CR 3.55 × IR 3.79 (p = 0.5). The mean radiotherapy dose was 49.1 Gy, with CR 47.3 × IR 50.0 (p = 0.06).
Conclusion It was not possible to demonstrate in this study a significant relationship between complete tumor response to neoadjuvant therapy with respect to blood leukocyte parameters analyzed.
Resumo
Introdução A abordagem radio-quimioterápica previa apresenta grande relevância no manuseio do câncer de reto, colaborando na preservação funcional do órgão, sendo realizada previamente à cirurgia. A resposta inflamatória tem papel importante neste tratamento.
Objetivo Consiste em correlacionar o número de linfócitos periféricos e a relação neutrófilos/linfócitos no sangue periférico com a resposta tumoral à terapia neo-adjuvante.
Métodos Revisão de prontuários dos pacientes portadores de câncer retal dos serviços de Oncologia do HMSJ e HSJ, desde 2009, casos submetidos ao tratamento neo-adjuvante com radio-quimioterapia.
Resultados Do total de 96 pacientes portadores desta enfermidade, submetidos à terapia neo-adjuvante com radio-quimioterapia foram elegíveis 35 pacientes, tendo sido observada resposta completa tumoral em 11 casos (31%), e nove foram submetidos ao tratamento cirúrgico. Na comparação dos parâmetros leucocitários entre os pacientes com resposta completa (RC) e resposta incompleta (RI) foram observados os seguintes valores: número total de leucócitos (média) RC 7390,9 × RI 7220,4 (p = 0,8); linfócitos totais RC 2103 × RI 1960,9 (p = 0,4); relação neutrófilo/linfócito RC 3,55 × RI 3,79 (p = 0,5). A dose radioterápica média foi de 49.1 Gy, sendo RC 47,3 × RI 50,0 (p = 0,06).
Conclusão Não foi possível demonstrar no presente estudo relação significativa entre resposta completa tumoral à terapia neo-adjuvante nos parâmetros analisados do perfil leucocitário.
Publication History
Received: 01 September 2014
Accepted: 28 September 2014
Article published online:
17 February 2021
© 2015. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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