title: Hematological parameters during concurrent chemoradiotherapy as potential prognosticators in patients with stage IIB cervical cancer.
abstract: We hypothesized that hemoglobin levels, absolute neutrophil count, and absolute lymphocyte count were associated with radiotherapy response and cancer progression and that they might reflect tumor repopulation during concurrent chemoradiotherapy. This study aimed to investigate these hematological parameters as prognosticators of cervical cancer. We analyzed 105 stage IIB cervical cancer patients treated with concurrent chemoradiotherapy, using log-rank tests and multivariate analyses. Hazard ratios were calculated weekly to evaluate changes in hemoglobin, absolute neutrophil count, and absolute lymphocyte count that were associated with disease-specific survival. Patients were categorized into the high hematological risk (patients with low hemoglobin plus high absolute neutrophil count and/or low absolute lymphocyte count) and the low hematological risk (others) groups according to the median cutoff values. During the second week of concurrent chemoradiotherapy, hematological factors were significantly associated with survival. In multivariate analysis, hematological risk was independently associated with disease-specific survival and progression-free survival. The 5-year disease-specific survival and progression-free survival rates in the high hematological risk group were significantly lower compared with those in the low hematological risk group (81.6% vs 92.6%, p = 0.0297; 73.7% vs 89.3%, p = 0.0163, respectively). During the second week of concurrent chemoradiotherapy, the hematological parameters could predict treatment outcome in stage IIB cervical cancer.
authors.affiliation: 1 Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Oyeon
authors.initials: O
authors.lastname: Cho
authors.affiliation: 1 Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: O Kyu
authors.initials: OK
authors.lastname: Noh
authors.affiliation: 1 Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Young-Taek
authors.initials: YT
authors.lastname: Oh
authors.affiliation: 2 Department of Obstetrics and Gynecology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.affiliation: 2 Department of Obstetrics and Gynecology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
authors.affiliation: 3 Department of Radiology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: 1 Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea.
authors.forename: Mison
authors.initials: M
authors.lastname: Chun
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000473:pathology / Q000628:therapy*
chemical_list: D002945:Cisplatin
keywords: Cervical cancer; chemoradiotherapy; hemoglobin; lymphocyte; neutrophil