Chemotherapy-related leukopenia as a biomarker predicting survival outcomes in locally advanced cervical cancer

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• 作者：Giorgio Bogani^a ; ^{giorgiobogani@yahoo.it} ; ^{giorgio.bogani@istitutotumori.mi.it} ; Ilaria Sabatucci^a ; Giuseppa Maltese^a ; Francesca Lecce^a ; Mauro Signorelli^a ; Fabio Martinelli^a ; Valentina Chiappa^a ; Alice Indini^a ; Umberto Leone Roberti Maggiore^b ; Chiara Borghi^c ; Giovanni Fucà ; ^a ; Antonino Ditto^a ; Francesco Raspagliesi^a ; Domenica Lorusso^a
• 关键词：Cervical cancer ; Leukopenia ; Neoadjuvant chemotherapy ; Survival
• 刊名：European Journal of Obstetrics & Gynecology and Reproductive Biology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：208
• 期：Complete
• 页码：41-45
• 全文大小：661 K
• 卷排序：208

文摘

To investigate the impact of hematologic toxicity and leukopenia in locally advanced cervical cancer patients undergoing neoadjuvant chemotherapy (NACT).Study designData of consecutive patients undergoing platinum-based NACT followed by surgery were retrospectively searched in order to evaluate the impact of chemotherapy-related toxicity on survival outcomes. Toxicity was graded per the Common Terminology Criteria for Adverse Events (CTCAEv.4.03). Survival outcomes were evaluated using Kaplan-Meir and Cox hazard models.ResultsOverall, 126 patients were included. Among those, 94 (74.6%) patients experienced grade2+ hematologic toxicity; while, grade2+ non-hematologic toxicity occurred in 11 (8.7%) patients. After a median follow-up of 37.1 (inter-quartile range, 12–57.5) months, 21 (16.6%) patients experienced recurrence. Via multivariate analysis, no factor was independently associated with disease-free survival; while a trend toward worse prognosis was observed for patients experiencing grade2+ leukopenia at cycle-3 (HR:3.13 (95%CI: 0.94, 10.3); p = 0.06). Similarly, grade2+ leukopenia (HR:9.98 (95%CI: 1.14, 86.6); p = 0.03), lymph-node positivity (HR:14.6 (95%CI:1.0, 214.4); p = 0.05) and vaginal involvement (HR:5.81 (95%CI:1.43, 23.6); p = 0.01) impacted on overall survival, at multivariate analysis. Magnitude of leukopenia correlated with survival (p<0.001).ConclusionsAlthough, our data have to be confirmed by prospective investigations, the present study shows an association between the occurrence of leukopenia and survival outcomes. NACT-related immunosuppression might reduce the response against the tumor, thus promoting cancer progression.