Pretreatment high cholesterol and low neutrophils predict complete pathological response after neoadjuvant short‑course radiotherapy followed by chemotherapy and immunotherapy in locally advanced rectal cancer

Fangyuan Zhang; Dandan Yu; Jinru Yang; Menglan Zhai; Lisha Li; Lei Zhao; Jing Wang; Tao Zhang; Zhenyu Lin

doi:10.3892/ol.2023.13905

Pretreatment high cholesterol and low neutrophils predict complete pathological response after neoadjuvant short‑course radiotherapy followed by chemotherapy and immunotherapy in locally advanced rectal cancer

Oncol Lett. 2023 Jun 7;26(1):319. doi: 10.3892/ol.2023.13905. eCollection 2023 Jul.

Authors

Fangyuan Zhang^{1

2}, Dandan Yu^{1

2}, Jinru Yang^{1

2}, Menglan Zhai^{1

2}, Lisha Li^{1

2}, Lei Zhao^{1

2}, Jing Wang^{1

2}, Tao Zhang^{1

2}, Zhenyu Lin^{1

2}

Affiliations

¹ Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
² Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.

Abstract

The present study was aimed at looking for hematological indicators that could predict pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) treated with short-course radiotherapy (SCRT) followed by chemotherapy and immunotherapy. A total of 171 patients were enrolled in this observational retrospective study. Pretreatment values of albumin, total cholesterol, lactate dehydrogenase, neutrophil, platelet and lymphocytes were available. Univariate and multivariate logistics analyses were used to determine the prognostic factor for pCR. SCRT followed by chemotherapy and immunotherapy was demonstrated to double the pCR rate (50.5%) compared with long-course chemoradiotherapy. For the former group, baseline high platelet to lymphocyte ratio (P=0.047), high cholesterol (P=0.026) and low neutrophils (P=0.012) level were associated with high pCR rate and baseline high cholesterol (P=0.016) and low neutrophils (P=0.020) level were the independent prognostic factors for pCR. In conclusion, pretreatment high cholesterol and low neutrophils were the independent prognostic predictors of pCR in patients with LARC treated with SCRT followed by chemotherapy and immunotherapy. Clinical trial no. NCT04928807, June 16, 2021.

Keywords: immunotherapy; locally advanced rectal cancer; pathological complete response; short-course radiotherapy.

Associated data

ClinicalTrials.gov/NCT04928807

Grants and funding

Shanghai Cancer Prevention and Anti-Cancer Development Foundation 2020 Discovery research funding (grant no. 2020HX025). CSCO Tongshu Oncology Research Fund (grant no. Y-tongshu2021/qn-0205). CSCO Xinda Oncology Immunotherapy Research Fund (grant no. Y-XD202002-0168).