Radiat Oncol J.  2016 Dec;34(4):305-312. 10.3857/roj.2016.01914.

Nodal tumor response according to the count of peripheral blood lymphocyte subpopulations during preoperative chemoradiotherapy in locally advanced rectal cancer

• Heo J
• Oh YT
• Noh OK
• Chun M
• Park JE
• Cho SR

• KMID: 2366052
• DOI: http://doi.org/10.3857/roj.2016.01914

Abstract

PURPOSE
The objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer.
MATERIALS AND METHODS
From August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. The absolute blood lymphocyte subpopulation was obtained prior to and after 4 weeks of CRT. We analyzed the association between a tumor response and change in the lymphocyte subpopulation during CRT.
RESULTS
Among 10 patients, 2 (20%) had evidence of pathologic complete response. In 8 patients with clinically node positive, 4 (50%) had nodal tumor response. All lymphocyte subpopulation counts at 4 weeks after CRT were significantly lower than those observed during pretreatment (p < 0.01). A high decrease in natural killer (NK) cell, count during CRT (baseline cell count − cell count at 4 weeks) was associated with node down staging (p = 0.034).
CONCLUSION
Our results suggest that the change of lymphocyte subset to preoperative CRT may be a predictive factor for tumor response in rectal cancer.

Keyword

Rectal neoplasms; Immunity; Lymphocytes; NK cells

MeSH Terms

Cell Count
Chemoradiotherapy*
Drug Therapy
Humans
Killer Cells, Natural
Lymphocyte Subsets*
Lymphocytes*
Prospective Studies
Radiotherapy
Rectal Neoplasms*