Article 2025 · 0 citations

New Parameters That May Predict Tumor Regression and Survival in Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

Buyukbayram, Mehmet Emin, Hannarici, Zekeriya, Turhan, Aykut, Golcuklu, Salih, Esdur, Pinar Coban, Bilici, Mehmet, Tekin, Salim Basol

Abstract

Aim: Locally advanced rectal cancer (LARC) is associated with high mortality. Although neoadjuvant chemoradiotherapy (nCRT) is the mainstay of treatment, the expected pathological response is inadequate. Research on total neoadjuvant treatment (TNT) is ongoing. This study aimed to investigate the significance of certain inflammatory and metabolic parameters in predicting treatment response and survival. Material and Methods: Data from 57 patients with LARC who underwent nCRT or TNT between 2010 and 2023 were retrospectively analyzed. The systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) were calculated from the results of the blood samples collected before the initiation of treatment, along with the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), Aand erythrocyte distribution width (RDW)-to-lymphocyte ratio (RLR). Results: Of the patients, 52 (91.2%) had adenocarcinoma, while 5 (8.8%) had mucinous or signet-ring histology. Among 55 patients with available data, 42 (76.4%) were clinically N+. Seven (12.3%) received TNT. According to the Dworak regression score, 48 (84.2%) had a poor, and 9 (15.8%) had a good response. Six (10.5%) patients had a pathological complete response. An increase in SII per 100 units (HR=1.081, 95% CI: 1.005-1.162, p=0.036) and in RLR (HR=1.197, 95% CI: 1.025-1.398, p=0.023) Awas significantly associated with disease-free survival (DFS) in univariate analysis, but not in the multiple model. Conclusion: There was no significant association between the Dworak regression score and the inflammatory and metabolic parameters in response to nCRT in LARC. AFurther studies are needed to determine the between the RLR, a novel and DFS.

Keywords

Blood glucose erythrocyte indices neoadjuvant therapy rectal neoplasms systemic immune-inflammation index CELL DISTRIBUTION WIDTH PROGNOSTIC SCORE INFLAMMATION CHEMOTHERAPY

WoS Categories

Medicine, General & Internal

Sustainable Development Goals

Good Health and Well-being

Citation

Journal: DUZCE MEDICAL JOURNAL
Year: 2025
Volume: 27
Issue: 3
Pages: 241-247
eISSN: 1307-671X
DOI: 10.18678/dtfd.1637275
WoS UID: WOS:001667451200001

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