The role of hematological parameters in predicting the response to radical chemoradiotherapy in patients with anal squamous cell cancer

Authors

  • Suzana Stojanovic-Rundic Clinic for Radiation Oncology and Diagnostics, Department of Radiation Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia;
  • Mladen Marinkovic Clinic for Radiation Oncology and Diagnostics, Department of Radiation Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • Milena Cavic Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • Vesna Plesinac Karapandzic Clinic for Radiation Oncology and Diagnostics, Department of Radiation Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia;
  • Dusica Gavrilovic Data Center, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • Radmila Jankovic Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • Richarda M. de Voer Department of Human Genetics, Rabdoud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
  • Sergi Castellvi-Bel Gastroenterology Department, Institut d’ Investigacions BiomèdiquesAugust Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Clínic, Barcelona, Spain
  • Zoran Krivokapic Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade, Serbia;

Abstract

Background: Historically, the treatment of choice for anal carcinoma (AC) had been abdominoperineal resection (APR), but radical radiotherapy with concurrent 5-fluorouracil plus mitomycin C chemotherapy (CRT) was later established as standard therapy, although with  a failure rate of 20–30%. The aim of this study was to evaluate the outcomes after radical CRT, prognostic and predictive factors and patterns of failure.

Patients and methods: This study included 47 patients treated with radical CRT for patohistologicaly confirmed anal squamous cell carcinoma. Analyzed haematological parameters included: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and haemoglobin level. Tumor response was assessed at 24 weeks from CRT completion. Follow-up was performed every 3 months during the first two years, and every 6 months thereafter.

Results: A complete clinical response (CR) was detected in 30 patients (63.8%). Patients who did not achieve a 6-months CR and those who had a CR after 6 months but then relapsed were referred to surgical treatment. With combined CRT and surgical salvage treatment CR rate was 80.9%. Patients with CR after 6 months had significantly increased DFS, PFS, and OS. The final logistic regression model included pretreatment haemoglobin level and treatment break period. A significant effect on the 6-month response was confirmed for PLR (p = 0.03).

Conclusions: Important prognostic factors associated with CR were baseline haemoglobin level and period of treatment interruptions. Potential haematological prognostic factors could be PLR and NLR, which can be routinely determined by low-cost and minimally invasive methods.

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Published

2021-12-20

How to Cite

Stojanovic-Rundic, S., Marinkovic, M., Cavic, M., Plesinac Karapandzic, V., Gavrilovic, D., Jankovic, R., M. de Voer, R., Castellvi-Bel, S., & Krivokapic, Z. (2021). The role of hematological parameters in predicting the response to radical chemoradiotherapy in patients with anal squamous cell cancer. Radiology and Oncology, 55(4), 449–458. Retrieved from https://radioloncol.com/index.php/ro/article/view/3702

Issue

Section

Clinical oncology