Abstract：Objective To evaluate the effects of the nadirs of neutrophils and lymphocytes during concurrent chemoradiotherapy (CCRT) on clinical prognosis of patients with cervical cancer,aiming to provide reference data for clinicians. Methods Clinical data of FIGO (2018)ⅠB1-ⅣA cervical cancer patients treated with radical CCRT inthe University of Hong Kong-Shenzhen Hospital,from January 2015 to September 2019 were analyzed. Routine blood test was performed weekly. The overall survival (OS) was calculated by Kaplan-Meier methodand analyzedby log-rank test.Univariate andMultivariate prognostic analysis were performed by Cox proportional hazards model. Results A total of 87 patients were included. The cutoff values of absolute neutrophil count nadir (ANCn) and absolute lymphocyte count nadir (ALCn) for predicting OS were determined by receiver operating characteristic curve. Compared with the ANCn of ≤2.14×109/L (n=76), patients with the ANCn of > 2.14×109/L (n=11) had lower 2-year OS rate (54.5% vs. 88.9%,P=0.035). Compared with ALCn of > 0.2×109/L (n=49), patients with ALCn of ≤0.2×109/L (n=38) obtained lower 2-year OS rate (75.3% vs. 90.8%,P=0.008). Multivariate analysis showed that ANCn (>2.14×109/L vs. ≤2.14×109/L)(HR=4.487,95%CI:1.404-14.344,P=0.011),ALCn (≤0.2×109/L vs. >0.2×109/L)(HR=5.814,95%CI:1.822-18.554,P=0.003),concurrent chemotherapy cycle (5-6 cycles vs. 0-4 cycles)(HR=0.204,95%CI:0.060-0.696,P=0.011) and the mean body radiation dose (HR=1.296,95%CI:1.125-1.493,P<0.001) were significantly associated with OS. Patients with the ANC of > 5.19×109/L before CCRT were more likely to have ANCn of > 2.14×109/L during CCRT and those with the ALC of < 2.05×109/L before CCRT was more likely to have ALCn of ≤0.2×109/L during CCRT. Conclusions Peripheral ANCn and ALCn during CCRT have different prognostic effects and influencing factors. Clinical prognosis of cervical cancer patients may be improved by closely monitoring routine blood parameters and optimizing treatment modality during CCRT.
Yang Li,Xu Zhiyuan,Wang Qian et al. Analysis of different prognostic effects of nadirs of neutrophils and lymphocytes during concurrent chemoradiotherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(11): 1148-1153.
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