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Objective To evaluate whether any association exists between peripheral blood cell-based inflammatory biomarkers obtained before adjuvant chemoradiotherapy and adverse events ( AEs) and survival of patients with pathological stage Ⅱ/Ⅲ rectal cancer treated by adjuvant chemoradiotherapy. Methods A total of 109 rectal cancer patients were included. The prognostic abilities of neutrophil to lymphocyte ratio ( NLR) , platelet to lymphocyte ratio ( PLR) , lymphocyte to monocyte ratio ( LMR) and neutrophil to albumin ratio ( NAR ) for overall survival ( OS ) were calculated by the receiver operating characteristic ( ROC) curves. Results NAR was associated with the occurrence of grade ≥2 leukopenia (OR=4. 442, 95％ CI:1. 216-16. 221, P<0. 05). The 5-year OS rates of patients with NAR ≥ 0. 055 and patients with NAR<0. 055 were 68. 2％ and 83. 9％, respectively ( P>0. 05) . The 5-year disease-free survival ( DFS) rates of patients with NAR ≥ 0. 055 and patients with NAR<0. 055 were 59. 1％ and 76. 8％, respectively (χ2 =3. 887, P<0. 05 ) . Multivariate analysis by Cox proportional-hazards model showed that NAR was significantly associated with OS (HR=3. 035, 95％ CI:1. 021-9. 019, P<0. 05). Conclusions These results suggest that NAR obtained before adjuvant chemoradiotherapy might serve as an independent biomarker for predicting AEs and prognosis in rectal cancer treated with adjuvant chemoradiotherapy.
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Objective@#To evaluate whether any association exists between peripheral blood cell-based inflammatory biomarkers obtained before adjuvant chemoradiotherapy and adverse events (AEs) and survival of patients with pathological stage Ⅱ/Ⅲ rectal cancer treated by adjuvant chemoradiotherapy.@*Methods@#A total of 109 rectal cancer patients were included. The prognostic abilities of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and neutrophil to albumin ratio (NAR) for overall survival (OS) were calculated by the receiver operating characteristic (ROC) curves.@*Results@#NAR was associated with the occurrence of grade ≥2 leukopenia (OR=4.442, 95% CI: 1.216-16.221, P<0.05). The 5-year OS rates of patients with NAR ≥ 0.055 and patients with NAR<0.055 were 68.2% and 83.9%, respectively (P>0.05). The 5-year disease-free survival (DFS) rates of patients with NAR ≥ 0.055 and patients with NAR<0.055 were 59.1% and 76.8%, respectively (χ2=3.887, P<0.05). Multivariate analysis by Cox proportional-hazards model showed that NAR was significantly associated with OS (HR=3.035, 95% CI: 1.021-9.019, P<0.05).@*Conclusions@#These results suggest that NAR obtained before adjuvant chemoradiotherapy might serve as an independent biomarker for predicting AEs and prognosis in rectal cancer treated with adjuvant chemoradiotherapy.
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PURPOSE: Mismatch repair (MMR) deficiency plays a critical role in rectal cancer. This study aimed to explore the associations between genetic variations in seven MMR genes and adverse events (AEs) and survival of patients with rectal cancer treated with postoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: Fifty single nucleotide polymorphisms in seven MMR (MLH1, MLH3, MSH2, MSH3, MSH6, PMS1 and PMS2) genes were genotyped by Sequenom MassARRAY method in 365 patients with locally advanced rectal cancer receiving postoperative CRT. The associations between genotypes and AEs were measured by odds ratios and 95% confidence intervals (CIs) by unconditional logistic regression model. The associations between genetic variations and survival were computed by the hazard ratios and 95% CIs by Cox proportional regression model. RESULTS: The most common grade ≥ 2 AEs in those 365 patients, in decreasing order, were diarrhea (44.1%), leukopenia (29.6%), and dermatitis (18.9%). Except 38 cases missing, 61 patients (18.7%) died during the follow-up period. We found MSH3 rs12513549, rs33013 and rs6151627 significantly associated with the risk of grade ≥ 2 diarrhea. PMS1 rs1233255 had an impact on the occurrence of grade ≥2 dermatitis. Meanwhile, PMS1 rs4920657, rs5743030, and rs5743100 were associated with overall survival (OS) time of rectal cancer. CONCLUSION: These results suggest that MSH3 and PMS1 polymorphisms may play important roles in AEs prediction and prognosis of rectal cancer patients receiving postoperative CRT, which can be potential genetic biomarkers for rectal cancer personalized treatment.