Gastrointestinal Cancer

PV QA 1 - Poster Viewing Q&A 1

SU_5_2046 - Outcomes Prediction in Pre-Operative Radiation Therapy Locally Advanced Rectal Cancer: Leucocyte Assessment As Immune Biomarker

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Outcomes Prediction in Pre-Operative Radiation Therapy Locally Advanced Rectal Cancer: Leucocyte Assessment As Immune Biomarker
A. Vallard1, M. A. Garcia2, S. Espenel3, P. Diao4, N. Vial2, J. B. Guy1, M. ben Mrad2, C. Rancoule1, A. Rehailia Blanchard5, G. Pigné1, D. Kaczmarek6, M. Peoc'h7, J. M. Phelip7, J. langrand-Escure1, and N. Magne1; 1Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France, 2Lucien Neuwirth Cancer Institute, SAint Priest en Jarez, France, 3Laboratoire de Radiobiologie Cellulaire et Moleculaire Lyon Sud, OULLINS, France, 4Sichuan cancer Hospital, Chengdu, China, 5ICL Lucien neuwirth, saint priest en jarez, France, 6Loire Private Hospital, Saint Etienne, France, 7North University Hospital, Saint Etienne, France

Purpose/Objective(s): 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).

Materials/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.

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.

Conclusion: 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.

Author Disclosure: A. Vallard: None. M. Garcia: None. P. Diao: None. J. Guy: None. M. ben Mrad: None. A. Rehailia Blanchard: None. D. Kaczmarek: None. J. langrand-Escure: None. N. Magne: None.

Send Email for Alexis Vallard


Assets

SU_5_2046 - Outcomes Prediction in Pre-Operative Radiation Therapy Locally Advanced Rectal Cancer: Leucocyte Assessment As Immune Biomarker



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Outcomes Prediction in Pre-Operative Radiation Therapy Locally Advanced Rectal Cancer: Leucocyte Assessment As Immune Biomarker