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  • [Int J Clin Oncol.] Prognostic impact of neutrophilia and lymphopenia on survival in anal cancer treated with definitive concurrent chemoradiotherapy: a retrospective multicenter study 근치적 항암화학방사선치료를 받은 항문암에서 호중구증가증 림프구감소증의 생존율에 대한 영향

    이화의대 / 김은지, 김태형, 김규보*,

  • 출처
    Int J Clin Oncol.
  • 등재일
    2022 Mar
  • 저널이슈번호
    27(3):553-562. doi: 10.1007/s10147-021-02094-5.
  • 내용

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    Abstract
    Purpose: This study evaluated the prognostic value of leukocyte, lymphocyte, and neutrophil counts in anal cancer patients undergoing concurrent chemoradiotherapy (CCRT).

    Methods: Multi-institutional retrospective data review included 148 non-metastatic anal cancer patients treated with definitive CCRT with 5-fluorouracil plus mitomycin C between the year 2001 and 2019. The median radiation dose to the primary tumor was 54 Gy with a median pelvic dose of 45 Gy. Median follow-up duration was 56 months, and complete blood cell counts were analyzed from baseline to 1 year after the completion of radiotherapy.

    Results: Although most patients showed a normal number of blood cells before treatment, 6.1% and 4.1% of patients showed leukocytosis (> 10,000/μl) and neutrophilia (> 7500/μl), respectively. After the initiation of treatment, seven patients (4.7%) displayed grade 4 lymphopenia (< 200/μl) at 1 month. Patients with initial leukocytosis showed inferior progression- and locoregional progression-free survival, and neutrophilia was a prognostic factor in all survival outcomes. Grade 4 lymphopenia at 1 month was also significantly associated with overall, progression-, and distant metastasis-free survival. On multivariate analyses, baseline neutrophilia was associated with 56.8-, 22.6-, 10.7-, and 23.0-fold increased risks of death, disease relapse, locoregional progression, and distant metastasis, respectively. Furthermore, lymphocytes < 200/μl at 1 month was linked to 6.8-, 5.4-, and 6.3-fold increased risks for death, disease relapse, and distant metastasis, respectively.

    Conclusion: The number of leukocytes, lymphocytes, and neutrophils readily acquired from routine blood tests before and during treatment could be an independent prognostic factor of survival in patients with anal cancer.

     

     

     

    Affiliations

    Eunji Kim #  1 , Tae Hyung Kim #  2   3 , Wonguen Jung  4 , Kyubo Kim  5 , Ah Ram Chang  6 , Hae Jin Park  7 , Hyeon Kang Koh  8 , Semie Hong  8 , Kyung Hwan Kim  2 , Jee Suk Chang  2 , Woong Sub Koom  2 , Won Il Jang  1 , Mi-Sook Kim  1
    1 Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
    2 Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
    3 Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
    4 Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea.
    5 Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea. kyubokim.ro@gmail.com.
    6 Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
    7 Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Korea.
    8 Department of Radiation Oncology, Konkuk University School of Medicine, Seoul, Korea.
    # Contributed equally.

  • 키워드
    Anal squamous cell carcinoma; Chemoradiotherapy; Lymphopenia; Neutrophilia; Survival.
  • 편집위원

    항문암에서 항암화학방사선치료의 치료성적을 예측할 수 있는 예후인자로 진단 시 호중구증가증과 치료 후 림프구감소증을 제시한 논문

    2022-05-04 16:08:21

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