The predictive value of nadir neutrophil count during treatment of cervical cancer: Interactions with tumor hypoxia and interstitial fluid pressure (IFP)

Clinical and Translational Radiation Oncology

卷:6

Melania Pintilie¹  Kieyan Sy²  Blaise Clarke²  Eric Leung³  Naz Chaudary⁴  Rachel Glicksman⁵  Michael Milosevic⁵  Kathy Han⁵  Anthony Fyles⁵  Richard P. Hill⁵ 

[1] Department of Biostatistics, Princess Margaret Cancer Centre and University Health Network, Toronto, Canada;

[2] Department of Pathology, Princess Margaret Cancer Centre and University Health Network, Toronto, Canada;

[3] Department of Radiation Oncology, Odette Regional Cancer Centre and Sunnybrook Hospital, Toronto, Canada;

[4] Ontario Cancer Institute and Campbell Family Institute for Cancer Research, Princess Margaret Cancer Centre and University Health Network, Toronto, Canada;

[5] Radiation Medicine Program, Princess Margaret Cancer Centre and University Health Network, Toronto, Canada;

关键词: Cervical cancer;    Radiation treatment;    Hypoxia;    Interstitial fluid pressure (IFP);    Neutrophils;    Immuno-oncology;   

DOI  :  10.1016/j.ctro.2017.08.002

来源: DOAJ

【 摘 要 】

Background and purpose: Hypoxia, high interstitial fluid pressure (IFP) and immune effects have individually been shown to modulate radiotherapy (RT) response in cervical cancer. The aim of this study was to investigate the interplay between hypoxia or IFP and circulating neutrophil levels, and their combined effect on survival following RT.Material and methods: A total of 287 FIGO stage IB to IIIB cervical cancer patients treated with RT or RT and cisplatin (RTCT) were included. Tumor hypoxia and IFP were measured at baseline prior to treatment. Absolute neutrophil count (ANC) was measured at baseline and weekly during treatment. Median follow up was 7.1 years.Results: High nadir ANC at the point of maximal myelosuppression was a stronger predictor of inferior survival than high baseline ANC after adjusting for clinical prognostic factors and treatment (RT vs. RTCT). The predictive effect of nadir ANC was most evident in patients with well-oxygenated tumors or tumors with high IFP at diagnosis.Conclusions: This study provides new information about the combined influence of the tumor microenvironment and myeloid cells on the survival of cervical cancer patients treated with RT/RTCT to motivate the development of new treatments based on molecular targeting of immune–based radioresistance pathways.

【 授权许可】

Unknown