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Meunier S, Frontczak A, Balssa L, Blanc J, Benhmida S, Pernot M, Quivrin M, Martin E, Hammoud Y, Créhange G, Boustani J. Elevated Baseline Neutrophil Count Correlates with Worse Outcomes in Patients with Muscle-Invasive Bladder Cancer Treated with Chemoradiation. Cancers (Basel) 2023; 15:cancers15061886. [PMID: 36980771 PMCID: PMC10047214 DOI: 10.3390/cancers15061886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The role of inflammation in the development and prognosis of bladder cancer (BC) is now established. We evaluated the significance of neutrophil-to-lymphocyte ratio (NLR) and neutrophil count (PNN) in patients with localized BC treated with chemoradiation. METHODS Clinical characteristics and baseline biological data were retrospectively collected. We tested the association between NLR, PNN, and overall survival (OS) and progression-free survival (PFS). RESULTS One hundred and ninety-four patients were included. Median PNN was 4000.0/mm3 [1500.0-16,858.0] and median NLR was 2.6 [0.6-19.2]. In patients with NLR > 2.6, median OS and PFS were lower (OS: 25.5 vs. 58.4 months, p = 0.02; PFS: 14.1 vs. 26.7 months, p = 0.07). Patients with PNN > 4000/mm3 had significantly lower OS (21.8 vs. 70.1 months, p < 0.001) and PFS (13.7 vs. 38.8 months, p < 0.001). Contrary to NLR, PNN > 4000/mm3 was associated with shorter OS and PFS in multivariate analysis. CONCLUSIONS Elevated PNN at baseline was associated with worse OS and PFS. NLR was not an independent prognostic factor.
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Affiliation(s)
- Sébastien Meunier
- Department of Radiation Oncology, Centre Georges François Leclerc, 21000 Dijon, France
| | - Alexandre Frontczak
- Department of Urology, University Hospital of Besançon, 25000 Besançon, France
| | - Loïc Balssa
- Department of Urology, University Hospital of Besançon, 25000 Besançon, France
| | - Julie Blanc
- Department of Biostatistics, Centre Georges François Leclerc, 21000 Dijon, France
| | - Salim Benhmida
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France
| | - Mandy Pernot
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France
| | - Magali Quivrin
- Department of Radiation Oncology, Centre Georges François Leclerc, 21000 Dijon, France
| | - Etienne Martin
- Department of Radiation Oncology, Centre Georges François Leclerc, 21000 Dijon, France
| | - Yasser Hammoud
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France
| | - Gilles Créhange
- Department of Radiation Oncology, Institut Curie, 92210 Saint-Cloud, France
| | - Jihane Boustani
- Department of Radiation Oncology, University Hospital of Besançon, 25000 Besançon, France
- INSERM, EFS BFC, UMR1098, RIGHT, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, University of Bourgogne Franche-Comté, 25000 Besançon, France
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2
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Lombard A, Mistry H, Aarons L, Ogungbenro K. Dose individualisation in oncology using chemotherapy-induced neutropenia: Example of docetaxel in non-small cell lung cancer patients. Br J Clin Pharmacol 2020; 87:2053-2063. [PMID: 33075149 DOI: 10.1111/bcp.14614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/25/2020] [Accepted: 10/09/2020] [Indexed: 11/28/2022] Open
Abstract
AIMS Chemotherapy-induced neutropenia has been associated with an increase in overall survival in non-small cell lung cancer patients. Therefore, neutrophil counts could be an interesting biomarker for drug efficacy as well as linked directly to toxicity. For drugs where neutropenia is dose limiting, neutrophil counts might be used for monitoring drug effect and for dosing optimisation. METHODS The relationship between drug effect on the first cycle neutrophil counts and patient survival was explored in a Phase III clinical trial where patients with non-small cell lung cancer were treated with docetaxel. Once the association has been established, dosing optimisation was performed for patients with severe toxicities (neutropenia) without compromising drug efficacy (overall survival). RESULTS After taking into account baseline prognostic factors, such as Eastern Cooperative Oncology Group performance status, smoking status, liver metastasis, tumour burden, neutrophil counts and albumin levels, a model-predicted drug effect on the first cycle neutrophil counts was strongly associated with patient survival (P = .005). Utilising this relationship in a dose optimisation algorithm, 194 out of 366 patients would have benefited from a dose reduction after the first cycle of docetaxel. The simulated 1-year survival probabilities associated with the original dose and the individualised dose were not different. CONCLUSION The strong relationship between drug effect on the first cycle neutrophil counts and patient survival suggests that this variable could be used to individualise dosing, possibly without needing pharmacokinetic samples. The algorithm highlights that doses could be reduced in case of severe haematological toxicities without compromising drug efficacy.
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Affiliation(s)
- Aurélie Lombard
- Centre for Applied Pharmacokinetic Research, University of Manchester, UK.,Division of Pharmacy and Optometry, University of Manchester, UK
| | - Hitesh Mistry
- Division of Pharmacy and Optometry, University of Manchester, UK.,Division of Cancer Sciences, University of Manchester, UK
| | - Leon Aarons
- Centre for Applied Pharmacokinetic Research, University of Manchester, UK.,Division of Pharmacy and Optometry, University of Manchester, UK
| | - Kayode Ogungbenro
- Centre for Applied Pharmacokinetic Research, University of Manchester, UK.,Division of Pharmacy and Optometry, University of Manchester, UK
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3
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Li L, Liu G, Lu H, Jin K, Zhai X, Zhou M, Duan Y, Yue K, Wu Y, Wang X. Pre-treatment circulating neutrophil count is an independent prognostic factor in oropharyngeal cancer. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1135. [PMID: 33240984 PMCID: PMC7576053 DOI: 10.21037/atm-20-5702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/04/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oropharyngeal cancer (OPC) is a type of head and neck squamous cell cancer, the incidence of which has increased in recent years. Many studies have reported a variety of prognostic markers of OPC, but they are either expensive or difficult to obtain. Therefore, we retrospectively studied the prognostic value of circulating neutrophil count (CNC) in patients with OPC, with the aim of providing a theoretical basis for further prognostic stratification. METHODS The clinicopathological data of 153 patients diagnosed with OPC from January 2010 to June 2017 were retrospectively analyzed. The CNC of each patient was measured before treatment. Then, the relationship between CNC and the clinicopathological characteristics of the patients was analyzed. The receiver operating characteristic (ROC) curve was used to calculate the cutoff value of CNC. The cox proportional hazards model was used to perform univariate and multivariate analysis of the relevant prognostic factors to determine the factors related to overall survival (OS) and progression-free survival (PFS). RESULTS The cutoff value for CNC was 4.48. Neutrophilia was significantly associated with disease stage, P16 status, and the type of therapy. In the univariate and multivariate analyses, CNC was found to be correlated with OS and PFS. Increased neutrophil count was predictive of poor OS (P<0.001) and PFS (P=0.001). Neutrophil count was an independent risk factor for OS (HR =2.09, 95% CI: 1.25-3.51, P=0.005) and PFS (HR =1.78, 95% CI: 1.10-2.88, P=0.02) in patients with OPC. CONCLUSIONS Pre-treatment CNC is an independent prognostic factor for OPC.
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Affiliation(s)
- Liang Li
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Department of Otolaryngology, Tianjin Children’s Hospital, Tianjin University Children’s Hospital, Tianjin, China
| | - Guangping Liu
- Department of Otolaryngology, Tianjin Children’s Hospital, Tianjin University Children’s Hospital, Tianjin, China
| | - Honglue Lu
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Department of Otolaryngology, the Affiliated Hospital of Chengde Medical College, Chengde, China
| | - Kai Jin
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Xiang Zhai
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Mengqian Zhou
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yuansheng Duan
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Kai Yue
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yansheng Wu
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Xudong Wang
- Department of Maxillofacial and E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
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4
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He Y, Li T, Liu J, Ou Q, Zhou J. Early onset neutropenia: a useful predictor of chemosensitivity and favorable prognosis in patients with serous ovarian cancer. BMC Cancer 2020; 20:116. [PMID: 32050944 PMCID: PMC7014607 DOI: 10.1186/s12885-020-6609-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 02/06/2020] [Indexed: 01/23/2023] Open
Abstract
Background Epithelial ovarian cancer (EOC) is the leading cause of gynecological cancer-associated deaths and a majority of its histological type is manifested as serous ovarian cancer (SOC). In this study, we investigated whether the timing of onset of chemotherapy-induced neutropenia (CIN) is related to chemotherapeutic response and disease outcome of SOC. Methods One hundred sixty-nine primary SOC patients receiving six doses of carboplatin plus paclitaxel adjuvant chemotherapy following cytoreductive surgery were retrospectively included in this research. CIN was grouped as early onset and late onset neutropenia depending on the timing of development. Development of CIN prior to or with administration of 3rd cycle of chemotherapy was listed as early onset neutropenia, while those CIN due to later stage chemotherapy were grouped into non-early type. The relevance of time of CIN onset with the clinical characteristics, chemotherapeutic response, progression free survival (PFS) and overall survival (OS) were determined and analyzed by using Kaplan–Meier curves, Logistic regression method, Cox proportional hazards models, and Chi-square tests. Results The age distribution of the patients was between 27 to 77 years. Fifty years was the median. No statistical significances of difference in age, FIGO stage, histological grade, tumor residual and lymph node invasion, as well as CA125 level in each CIN group were found (all P>0.05). The patients from non-early onset group showed higher chemoresistance rates (78.33%) compared to those from early onset group (9.17%). Additionally, patients in early onset group showed improved median PFS (23 vs. 9 months; P<0.001) and median OS (55 vs.24 months; P<0.001). Conclusions Early onset neutropenia may be potentially used as a potential indicator for chemosensitivity and favorable prognosis of SOC in patients who underwent six cycles of carboplatin plus paclitaxel adjuvant chemotherapy following primary cytoreductive surgery.
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Affiliation(s)
- Yijing He
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Ting Li
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Jue Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Qiong Ou
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Junlin Zhou
- Clinical Research Institute, The First Affiliated Hospital of University of South China, Hengyang, China.
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5
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Score of the preoperative absolute number of lymphocytes, monocytes, and neutrophils as a prognostic indicator for patients with gastric cancer. Surg Today 2019; 49:850-858. [PMID: 31062094 DOI: 10.1007/s00595-019-01817-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/08/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The association between the preoperative absolute neutrophil count (NC), lymphocyte count (LC), and monocyte count (MC) in the peripheral blood and the prognosis of gastric cancer (GC) patients has not been investigated widely. METHODS We enrolled 445 patients who underwent surgery for GC between January, 2005 and April, 2013 to analyze the correlations among NC, LC, and MC and their prognoses. RESULTS Based on cut-off values calculated by ROC analysis, patients were sub grouped as having: NC ≥ 4477 (NCHigh), NC < 4477 (NCLow); and as LC ≥ 1447 (LCHigh), LC < 1447 (LCLow); and as MC ≥ 658.5 (MCHigh), MC < 658.5 (MCLow). Each group was assigned as follows; NCHigh group = 1, NCLow group = 0, LCHigh group = 0, LCLow group = 1, MCHigh group = 1, MCLow group = 0, and the sum of each score was defined as the lymphocyte-monocyte-neutrophil score (LMN score). The overall 5-year survival rates were 89%, 74%, 57.8%, and 53.3% for LMN scores of 0, 1, 2, and 3, respectively (P = 0.0004). Multivariate analysis indicated that the LMN score was an independent prognostic indicator. CONCLUSIONS The combination of preoperative NC, LC, and MC appears to be a useful indicator of GC prognosis.
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Kasi PM, Grothey A. Chemotherapy-Induced Neutropenia as a Prognostic and Predictive Marker of Outcomes in Solid-Tumor Patients. Drugs 2019; 78:737-745. [PMID: 29754293 DOI: 10.1007/s40265-018-0909-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chemotherapy-induced neutropenia (CIN) is one of the most common side effects seen in cancer patients. As an adverse event, it is deemed undesirable since it often constitutes a dose-limiting toxicity for cytotoxic agents leading to treatment delays and/or dose reductions. It is also associated with a financial cost component from diagnostic work-up and treatment of patients with chemotherapy-induced febrile neutropenia (CIFN). Neutropenia is commonly accompanied by a decrease in other hematopoietic lineages (anemia and/or thrombocytopenia). Dosing of chemotherapeutic agents is based on the severity of adverse effects seen. Depending on the degree of neutropenia, chemotherapeutic agents may be put on hold until count recovery and growth factor support might be added to allow for dosing as scheduled. However, neutropenia appears to be more than just an adverse event. While CIFN by itself constitutes an adverse event, the appearance of just CIN is not necessarily a marker of poor outcome. In fact, it rather appears to be a surrogate marker of response and/or survival in patients treated with cytotoxic regimens. Here we present evidence in different tumor types treated with different regimens on the role CIN plays as a marker for improved outcomes. If CIN is a surrogate prognostic and/or potentially predictive marker of response, chemotherapy doses may need to be escalated to achieve neutropenia. In addition, instead of reducing treatment doses for safety concerns, the addition of growth factor support and alternative dosing schemes may be strategies to consider.
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Affiliation(s)
| | - Axel Grothey
- Division of Medical Oncology, College of Medicine/Oncology, Mayo Clinic, Gonda 10, 200 First St SW, Rochester, MN, 55905, USA.
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7
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Liu L, Hong YL, Liu GY. Role of rational diet in postoperative treatment of gastric cancer and application prospect of traditional Chinese medicine diet. Shijie Huaren Xiaohua Zazhi 2018; 26:2057-2063. [DOI: 10.11569/wcjd.v26.i35.2057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The toxic side effects of postoperative radiotherapy and chemotherapy in gastric cancer (GC) often cause patients to have cancer cachexia and poor quality of life. Dietary adjuvant therapy can significantly promote GC patients to recover the body function, alleviate inflammation, improve anticancer treatment tolerance, improve postoperative quality of life and prolong survival. Given the advantages of diet in the postoperative treatment of GC, this paper discusses the role of modern medicine's elemental nutrition diet and traditional Chinese medicine diet in the postoperative treatment of GC, which can help clinicians better understand traditional Chinese medicine treatment in relieving the overall dysfunction of the body. Furthermore, the combination of traditional Chinese medicine diet with the modern medical nutrition diet evaluation system can expand the use of traditional Chinese medicine diet in the clinical treatment of GC.
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Affiliation(s)
- Lei Liu
- School of Pharmaceutical Sciences Xiamen University, Huayan Science and Technology Cancer Prevention and Rehabilitation Research Center, Xiamen 361000, Fujian Province, China
| | - Yu-Ling Hong
- School of Pharmaceutical Sciences Xiamen University, Huayan Science and Technology Cancer Prevention and Rehabilitation Research Center, Xiamen 361000, Fujian Province, China
| | - Guo-Yan Liu
- Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University, Xiamen 361000, Fujian Province, China
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Yeo B, Redfern AD, Mouchemore KA, Hamilton JA, Anderson RL. The dark side of granulocyte-colony stimulating factor: a supportive therapy with potential to promote tumour progression. Clin Exp Metastasis 2018; 35:255-267. [PMID: 29968171 DOI: 10.1007/s10585-018-9917-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/26/2018] [Indexed: 12/15/2022]
Abstract
Granulocyte-colony stimulating factor (G-CSF) is one of several cytokines that can expand and mobilize haematopoietic precursor cells from bone marrow. In particular, G-CSF mobilizes neutrophils when the host is challenged by infection or tissue damage. Severe neutropenia, or febrile neutropenia is a life-threatening event that can be mitigated by administration of G-CSF. Consequently, G-CSF has been used to support patients undergoing chemotherapy who would otherwise require dose reduction due to neutropenia. Over the past 10-15 years it has become increasingly apparent, in preclinical tumour growth and metastasis models, that G-CSF can support tumour progression by mobilization of tumour-associated neutrophils which consequently promote tumour dissemination and metastasis. With the increasing use of G-CSF in the clinic, it is pertinent to ask if there is any evidence of a similar promotion of tumour progression in patients. Here, we have reviewed the preclinical and clinical data on the potential contribution of G-CSF to tumour progression. We conclude that, whilst the evidence for a promotion of metastasis is strong in preclinical models and that limited data indicate that high serum G-CSF levels in patients are associated with poorer prognosis, no studies published so far have revealed evidence of increased tumour progression associated with supportive G-CSF use during chemotherapy in patients. Analysis of G-CSF receptor positive cohorts within supportive trials, as well as studies of the role of G-CSF blockade in appropriate tumours in the absence of chemotherapy could yield clinically translatable findings.
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Affiliation(s)
- Belinda Yeo
- Olivia Newton-John Cancer Research Institute and La Trobe University School of Cancer Medicine, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,Austin Health, Heidelberg, VIC, 3084, Australia
| | | | - Kellie A Mouchemore
- Peter MacCallum Cancer Centre, Parkville, VIC, Australia.,Department of Biochemistry & Molecular Biology, Monash University, Clayton, VIC, Australia
| | - John A Hamilton
- Arthritis and Inflammation Research Centre, Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, Australia
| | - Robin L Anderson
- Olivia Newton-John Cancer Research Institute and La Trobe University School of Cancer Medicine, 145 Studley Road, Heidelberg, VIC, 3084, Australia.
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Saito T, Sugiyama K, Hama S, Yamasaki F, Takayasu T, Nosaka R, Muragaki Y, Kawamata T, Kurisu K. Prognostic importance of temozolomide-induced neutropenia in glioblastoma, IDH-wildtype patients. Neurosurg Rev 2017; 41:621-628. [PMID: 28887717 DOI: 10.1007/s10143-017-0903-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 11/25/2022]
Abstract
Standard treatment for patients with primary glioblastoma (GBM) includes surgery, radiotherapy, and concomitant and adjuvant temozolomide (TMZ). Recent reports have demonstrated that TMZ-induced myelosuppression correlates with survival in patients with GBM. However, those results were evaluated before the 2016 revision of the World Health Organization classification. This study examined whether myelosuppression during concomitant TMZ phase correlates with prognosis in GBM, IDH-wildtype patients. We examined circulating blood cell counts in 50 patients with GBM, IDH-wildtype who received the standard treatment protocol between August 2005 and November 2015. We assessed relationships between rates of decrease in blood cells (white blood cells (WBC), neutrophils, lymphocytes, red blood cells, and platelets) during the concomitant TMZ phase and overall survival (OS) using univariate and multivariate analyses including other clinicopathological factors (age, sex, Karnofsky Performance Status (KPS), extent of resection, O6-methylguanine-DNA methyltransferase (MGMT) status). Log-rank testing revealed that age, KPS, extent of resection, MGMT status, and decrease rates of WBC, neutrophils, and platelets correlated significantly with OS. On multivariate analysis, age, MGMT status, and decrease rate of neutrophils correlated significantly with OS. Patients with a ≥ 40% decrease in neutrophils showed significantly longer OS than those with < 40% (hazard ratio = 2.815; 95% confidence interval = 1.177-7.038; P = 0.0196). A decrease of ≥ 40% in neutrophils represents a predictor of good prognosis for GBM, IDH-wildtype. Blood cell counts during the concomitant TMZ phase can help predict OS in patients with GBM, IDH-wildtype receiving the standard treatment protocol.
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Affiliation(s)
- Taiichi Saito
- Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. .,Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital, Hiroshima, Japan
| | - Seiji Hama
- Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Takeshi Takayasu
- Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Ryo Nosaka
- Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Kaoru Kurisu
- Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Sumner WA, Stokes WA, Oweida A, Berggren KL, McDermott JD, Raben D, Abbott D, Jones B, Gan G, Karam SD. Survival impact of pre-treatment neutrophils on oropharyngeal and laryngeal cancer patients undergoing definitive radiotherapy. J Transl Med 2017; 15:168. [PMID: 28764811 PMCID: PMC5539641 DOI: 10.1186/s12967-017-1268-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 07/19/2017] [Indexed: 11/12/2022] Open
Abstract
Background Squamous cell carcinoma of the head and neck (HNSCC) represents an array of disease processes with a generally unfavorable prognosis. Inflammation plays an important role in tumor development and response to therapy. We performed a retrospective analysis of HNSCC patients to explore the relationship of the lymphocyte and neutrophil counts, the neutrophil-to-lymphocyte ratio (NLR) overall survival (OS), cancer-specific survival (CSS), local control (LC) and distant control (DC). Materials/methods All patients received definitive treatment for cancers of the oropharynx or larynx between 2006–2015. Neutrophil and lymphocyte counts were collected pre-, during-, and post-treatment. The correlations of patient, tumor, and biological factors to OS, CSS, LC and DC were assessed. Results 196 patients met our inclusion criteria; 171 patients were Stage III or IV. Median follow-up was 2.7 years. A higher neutrophil count at all treatment time points was predictive of poor OS with the pre-treatment neutrophil count and overall neutrophil nadir additionally predictive of DC. Higher pre-treatment and overall NLR correlated to worse OS and DC, respectively. Conclusion A higher pre-treatment neutrophil count correlates to poor OS, CSS and DC. Lymphocyte counts were not found to impact survival or tumor control. Higher pre-treatment NLR is prognostic of poor OS. Electronic supplementary material The online version of this article (doi:10.1186/s12967-017-1268-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Whitney A Sumner
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - William A Stokes
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ayman Oweida
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kiersten L Berggren
- Department of Internal Medicine, Section of Radiation Oncology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Jessica D McDermott
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, USA
| | - David Raben
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Diana Abbott
- Department of Biostatistics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Bernard Jones
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gregory Gan
- Department of Internal Medicine, Section of Radiation Oncology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Sana D Karam
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
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11
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Liu R, Huang M, Zhao X, Peng W, Sun S, Cao J, Ji D, Wang C, Guo W, Li J, Yin J, Zhu X. Neutropenia predicts better prognosis in patients with metastatic gastric cancer on a combined epirubicin, oxaliplatin and 5-fluorouracil regimen. Oncotarget 2016; 6:39018-27. [PMID: 26528696 PMCID: PMC4770753 DOI: 10.18632/oncotarget.5730] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/06/2015] [Indexed: 12/26/2022] Open
Abstract
Chemotherapy-induced neutropenia (CIN) reportedly indicated better prognosis for some cancers. We retrospectively analyzed 150 evaluable metastatic gastric cancer (MGC) patients who had received first-line EOF5 (combination regimen of epirubicin, oxaliplatin and 5-day continuous infusion of 5-fluorouracil) treatment. We divided patients into three groups according to the worst grade of CIN: absent group (grade 0), moderate group (grade 1–2) and severe group (grade 3–4). Multivariate analyses of overall survival (OS) proved moderate and severe CIN were important prognostic factors whether regarding CIN as a time-varying covariate (TVC) or not. Compared with absent CIN, hazard ratio (HR) for moderate and severe CIN were 0.31 (95% confidential interval (CI): 0.17–0.55; P < 0.001) and 0.36 (95% CI: 0.20–0.64; P = 0.001) respectively with TVC; and were 0.31 (95% CI: 0.17–0.56; P < 0.001) and 0.34 (95% CI: 0.19–0.61; P < 0.001) respectively without TVC. In progression-free survival (PFS) analyses, moderate and severe CIN showed similar results. In the landmark group (n = 122 patients) analyses with TVC, moderate and severe CIN remained prognostic factors for PFS, while only moderate CIN was prognostic factor for OS. CIN predicted longer OS and PFS in MGC patients treated with first-line EOF5 chemotherapy.
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Affiliation(s)
- Rujiao Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Mingzhu Huang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Xiaoying Zhao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Wei Peng
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Si Sun
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Jun Cao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Dongmei Ji
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Chenchen Wang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Weijian Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Jin Li
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Jiliang Yin
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Xiaodong Zhu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
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Ma RM, Chen CZ, Zhang W, You J, Huang DP, Guo GL. Prognostic Value of Chemotherapy-Induced Neutropenia at the First Cycle in Invasive Breast Cancer. Medicine (Baltimore) 2016; 95:e3240. [PMID: 27043697 PMCID: PMC4998558 DOI: 10.1097/md.0000000000003240] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Chemotherapy-induced neutropenia (CIN) was the most apparent side effects of bone marrow suppression with adjuvant chemotherapy. Recently, several studies revealed that CIN may predict better outcomes. However, the researches upon breast cancer were still indefinite. We reviewed the female patients with pathologically diagnosed invasive breast cancer at the First Affiliated Hospital of Wenzhou Medical University, between Jan 2008 and Dec 2010. The lowest neutrophil counts in the second week after the first cycle of chemotherapy were collected. Clinicopathological characteristics and survival rates were compared and analyzed between the CIN group and non-CIN group. The median follow-up time was 62 months. The differences of over-all survival and local recurrence-free survival between the 2 groups were nonsense (P = 0.938, P = 0.695, respectively). But the disease-free survival and distant metastasis-free survival of the CIN group were statically significantly better (HR = 0.391, P = 0.009, and HR = 0.315, P = 0.005, respectively). The bone metastasis-free survival may be responsible for the differences (HR = 0.469, P = 0.005). Subgroup analyses showed the CIN may predict lower bone metastases rates with ER positive status, premenopause or younger age (≤ 40) (P = 0.002, P = 0.004, and P = 0.0001, respectively). Cox analysis showed younger ages, N staging, and the presence of CIN were associated with bone metastasis-free survival independently adjusting to peritumoral vascular invasion (P < 0.05). CIN may predict a decreased recurrence risk of breast cancer, especially bone metastases.
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Affiliation(s)
- Rui-Min Ma
- From the Department of Oncology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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