Abstract
BackgroundTo investigate the relationship between hematologic test results and the predictive effect of regression of esophageal cancer after neoadjuvant chemotherapy (NACT), we analyzed pre-NACT hematologic data and their relationship to tumor regression.MethodsThirty-eight consecutive patients with locally advanced squamous cell esophageal carcinoma who had undergone two cycles of paclitaxel/carboplatin NACT were enrolled. On the day prior to the first cycle of chemotherapy, hematologic tests, including routine blood test and biochemical examinations, were recorded. All patients were confirmed to have no history of hepatitis. Surgical resection was performed when clinical restaging showed effective regression. Histopathological examination was routinely performed to evaluate the postoperative effects of chemotherapy.ResultsAfter two cycles of NACT, tumor imaging evaluation showed that 27 of the 38 patients had CR and PR, including 25 patients who underwent radical esophagectomies. Six patients had stable disease and five patients had progressive disease. According to the hematologic test results before NACT, patients with higher white blood cell counts, lymphocyte percentages, mononuclear cell counts, neutrophilic granulocyte counts, and eosinophilic granulocyte counts and lower alanine aminotransferase (ALT) level had a significantly greater opportunity for an effective response.ConclusionBasal host immunologic function and hepatic function are associated with tumor response to NACT in patients with esophageal cancer. These parameters may have a certain predictive efficacy on NACT for esophageal squamous cell carcinoma.
Highlights
To investigate the relationship between hematologic test results and the predictive effect of regression of esophageal cancer after neoadjuvant chemotherapy (NACT), we analyzed pre-NACT hematologic data and their relationship to tumor regression
To determine the tumor regression and response to NACT, we evaluated the primary site with respect to morphological changes that have been previously described as typical of chemotherapy-induced changes in adenocarcinomas
We found that the hematologic cell level with respect to the basal host reaction, such as the white blood cell count, lymphocyte percentage, mononuclear cell count, neutrophilic granulocyte count, and eosinophilic granulocyte count, are related to the treatment efficacy
Summary
To investigate the relationship between hematologic test results and the predictive effect of regression of esophageal cancer after neoadjuvant chemotherapy (NACT), we analyzed pre-NACT hematologic data and their relationship to tumor regression. Almost 400,000 new cases of esophageal cancer are diagnosed annually. Esophageal squamous cell carcinoma (ESCC) is a major histological form of esophageal cancer in Asian countries. It is one of the most lethal malignancies of the digestive tract, and in most cases the initial diagnosis is established only once the malignancy reaches the advanced stage. The initial response rate for NACT remains at 35% to 66% [6] and non-responders are at risk for serious adverse effects, with no survival benefit
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