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• W2800230701 abstract "// Alexis Vallard 1 , Max-Adrien Garcia 2 , Peng Diao 3 , Sophie Espenel 1 , Guy de Laroche 1 , Jean-Baptiste Guy 1 , Majed Ben Mrad 1 , Chloé Rancoule 1 , David Kaczmarek 4 , Thierry Muron 5 , Gregoire Pigné 1 , Jack Porcheron 6 , Michel Peoc'h 7 , Jean-Marc Phelip 8 , Julien Langrand-Escure 1 and Nicolas Magné 1 1 Department of Radiation Oncology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France 2 Public Health Department, Hygée Institute, Saint Priest en Jarez, France 3 Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China 4 Department of Thoracic and Digestive Surgery, Private Loire Hospital (HPL), Saint Etienne, France 5 Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France 6 Department of Digestive and Oncologic Surgery, North University Hospital, Saint Priest en Jarez, France 7 Department of Pathology, North University Hospital, Saint Priest en Jarez, France 8 Department of Hepatology and Gastroenterology, North University Hospital, Saint Priest en Jarez, France Correspondence to: Nicolas Magné, email: nicolas.magne@icloire.fr Keywords: rectal cancer; chemoradiation; neutrophil; lymphocyte; ratio Received: September 01, 2017      Accepted: March 19, 2018      Published: April 27, 2018 ABSTRACT Objective: Leukocytes are hypothesized to reflect the inflammatory tumor microenvironment. We aimed to validate their prognostic significance in a large cohort of patients treated with pre-operative radiation for locally advanced rectal cancer (RC). Results: From 2004 to 2015, 257 RC patients with available biological data underwent a pre-operative radiotherapy, with a median age of 66 years. The median rectal EQD2 was 49.2Gy. Most of patients experienced concurrent chemotherapy ( n = 245, 95.4%), mainly with 5-FU (83.3%). Clear surgical margins (i.e. complete resection) were achieved in 234 patients (91.1%). A complete (Mandard TRG1: n = 35, 13.6%) or almost complete pathological response (Mandard TRG2: n = 56, 21.8%) were achieved in 91 patients (35.4%). With a median follow-up of 46.1 months, 8 patients (3.1%) experienced local relapse, 38 (14.8%) experienced metastases and 45 (17.5%) died. Elevated pre-radiation neutrophil to lymphocyte ratio (NLR > 2.8) was identified as an independent predictive factor of increased local relapse, of decreased progression-free survival and overall survival in multivariate analysis. Elevated NLR was marginally associated with incomplete pathological response in multivariate analysis, suggesting a possible value as a biomarker of radio-sensitivity. Conclusions: Pre-radiation NLR is a simple and robust biomarker for risk stratification in locally advanced RC patients undergoing pre-operative radiotherapy, and might select the subpopulation eligible to treatment intensification or to neoadjuvant chemotherapy. Material and Methods: Clinical records from consecutive patients treated in a single institution between 2004 and 2015 with curative-intent radiotherapy were retrospectively analyzed. Classical prognosis factors of RC and peripheral immune markers based on lymphocytes and neutrophil counts were studied." @default.
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• W2800230701 date "2018-04-27" @default.
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• W2800230701 title "Outcomes prediction in pre-operative radiotherapy locally advanced rectal cancer: leucocyte assessment as immune biomarker" @default.
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• W2800230701 doi "https://doi.org/10.18632/oncotarget.25023" @default.
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