Low cardiac dose and neutrophil-to-lymphocyte ratio predict overall survival in inoperable esophageal squamous cell cancer patients after chemoradiotherapy

Ho, Yu-Chieh; Lai, Yen‐Chung; Lin, Hung‐Yu; Ko, Ming-Hui; Wang, Sheng-Hung; Yang, Shun-Cheng; Lin, Ping‐Yi; Chou, Tsai-Wei; Hung, Li-Chung; Huang, Chia‐Wei; Chang, Tse Wen; Lin, Joseph; Lin, Jin‐Ching

doi:10.1038/s41598-021-86019-2

Cited by 6 publications

(10 citation statements)

References 53 publications

(22 reference statements)

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“…We first compared the 10 patients whose disease progressed with the 74 other patients who underwent surgery, and the multivariate logistic analysis demonstrated that the length of the lesion, the NLR before nCRT, and the amount of change in haemoglobin were independent predictors of PD. This is consistent with most previous studies, indicating that a high NLR is indeed an adverse factor for nCRT ( 12 , 13 , 16 , 29 ). Then, we turned our attention to the pCR group.…”

Section: Discussionsupporting

confidence: 93%

“…Hence, researchers have been looking for new predictors for the efficacy of nCRT. The NLR is an indicator of inflammation that has been linked with the prognosis of oesophageal cancer and other tumours in many studies (9)(10)(11)(12)(13)(14)(15)(16). Sun Yat-sen University Cancer Center retrospectively analysed 306 ESCC patients who underwent nCRT and found that the NLR before nCRT and the PLR after nCRT were independent predictors of pCR (17).…”

Section: Introductionmentioning

confidence: 99%

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The predictive value of peripheral blood cells and lymphocyte subsets in oesophageal squamous cell cancer patients with neoadjuvant chemoradiotherapy

Zhou

Lin

et al. 2022

Front. Immunol.

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PurposeNeoadjuvant chemoradiotherapy (nCRT) is a standard treatment option for patients with stage III oesophageal cancer. Approximately 30% of oesophageal cancer patients will have a pathological complete response (pCR) after nCRT. However, available clinical methods cannot accurately predict pCR for patients. We aimed to find more indicators that could be used to predict the pathological response to nCRT.MethodA total of 84 patients with stage III oesophageal squamous cell cancer were enrolled in this study. Ten patients failed to have surgery as a result of progressive disease (PD). Among the patients who underwent surgery, 32 patients had a pathologic complete response (pCR), whereas 42 patients showed no or partial response (npCR) after nCRT. Routine blood test results and lymphocyte subset assessments before and after nCRT were retrospectively analysed. Univariate and multivariate analyses were used to identify independent predictors of the clinical curative effect of nCRT. Eventually, nomograms were established for predicting the PD and pCR rates.ResultsThe numbers of lymphocytes, B lymphocytes, T lymphocytes, Th lymphocytes, Ts lymphocytes, and NK cells and the percentages of B lymphocytes and NK cells were decreased significantly after nCRT (P < 0.0001), whereas the percentages of T lymphocytes and Ts lymphocytes increased (P < 0.0001). Univariate analysis showed that age, the length of the lesion, the level of haemoglobin before nCRT, and the amount of change in haemoglobin were related to PD, and the percentage of NK cells after nCRT was related to pCR. Multivariate logistic analysis demonstrated that the length of the lesion, the neutrophil-to-lymphocyte ratio (NLR) before nCRT, and the amount of change in haemoglobin were independent predictors of PD, whereas the percentage of NK cells after nCRT was an independent predictor of pCR.ConclusionLymphocyte subsets changed dramatically during nCRT, and these changes together with baseline and posttreatment lymphocyte subsets have predictive value in determining the response to nCRT for oesophageal cancer.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The predictive value of peripheral blood cells and lymphocyte subsets in oesophageal squamous cell cancer patients with neoadjuvant chemoradiotherapy

Zhou

Lin

et al. 2022

Front. Immunol.

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“…This observation can be of major clinical importance in view of key roles for neutrophils in CVD ( 34 ) and a recent report on a link between the severity of aortic stenosis and NETosis ( 35 ). Furthermore, the neutrophil-to-lymphocyte ratio has been associated with worse patient survival after chemoradiotherapy ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

“…The cholesterol-rich diet modified the expression of 1.102 (898 unique human orthologs) genes in the aorta, 612 (492) genes in the aortic valve, 281 (229) genes in the mitral valve, and only 4 (3) and 6 (6) genes in the tricuspid and pulmonary valve, respectively. The lard-rich diet yielded much less DEGs than the cholesterol-rich diet, comprising 76 (66) genes in the aorta and 40 (36) genes in the aortic valve. No DEGs were found in the three other cardiac valves in response to the lard diet.…”

Section: Differential Rna Expression Profiles In the Aorta Aortic Val...mentioning

confidence: 99%

Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve

Donis

Jiang

D'Emal

et al. 2022

Front. Cardiovasc. Med.

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AimsDietary cholesterol and palmitic acid are risk factors for cardiovascular diseases (CVDs) affecting the arteries and the heart valves. The ionizing radiation that is frequently used as an anticancer treatment promotes CVD. The specific pathophysiology of these distinct disease manifestations is poorly understood. We, therefore, studied the biological effects of these dietary lipids and their cardiac irradiation on the arteries and the heart valves in the rabbit models of CVD.Methods and ResultsCholesterol-enriched diet led to the thickening of the aortic wall and the aortic valve leaflets, immune cell infiltration in the aorta, mitral and aortic valves, as well as aortic valve calcification. Numerous cells expressing α-smooth muscle actin were detected in both the mitral and aortic valves. Lard-enriched diet induced massive aorta and aortic valve calcification, with no detectable immune cell infiltration. The addition of cardiac irradiation to the cholesterol diet yielded more calcification and more immune cell infiltrates in the atheroma and the aortic valve than cholesterol alone. RNA sequencing (RNAseq) analyses of aorta and heart valves revealed that a cholesterol-enriched diet mainly triggered inflammation-related biological processes in the aorta, aortic and mitral valves, which was further enhanced by cardiac irradiation. Lard-enriched diet rather affected calcification- and muscle-related processes in the aorta and aortic valve, respectively. Neutrophil count and systemic levels of platelet factor 4 and ent-8-iso-15(S)-PGF2α were identified as early biomarkers of cholesterol-induced tissue alterations, while cardiac irradiation resulted in elevated levels of circulating nucleosomes.ConclusionDietary cholesterol, palmitic acid, and cardiac irradiation combined with a cholesterol-rich diet led to the development of distinct vascular and valvular lesions and changes in the circulating biomarkers. Hence, our study highlights unprecedented specificities related to common risk factors that underlie CVD.

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“…In addition, NLR was also reported as a meaningful predictor of outcome in patients with extensive small-cell lung cancer who received radiation treatment ( 26 ). It was reported that radiotherapy also reduced the level of NLR, which may contribute to a longer survival time, even in patients with advanced or metastatic disease ( 27 ). Although the above clinical evidence reported a meaningful predictive value of NLR/LMR/PLR in practice, few basic experiments were conducted to investigate the intrinsic mechanism for the phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Changes in Neutrophil to Lymphocyte Ratio, Lymphocyte to Monocyte Ratio, and Platelet to Lymphocyte Ratio During Palliative Radiotherapy May Predict Efficacy of Immune Checkpoint Inhibitor as Re-Challenge Treatment in Advanced Gastric Cancer: A Case Report

Chen

Zhu

et al. 2022

Front. Oncol.

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IntroductionImmunotherapy with programmed death-1 (PD-1) inhibitors has emerged as frontline option in patients with advanced or metastatic gastric cancer. However, two-thirds of patients who received PD-1 inhibitors treatment still had disease progression in 1 year. Subsequent treatment strategies as salvage options always lead to limited efficacy.Case DescriptionHerein, we presented a case of recurrent metastatic gastric adenocarcinoma that had progressed on first-line treatment with nivolumab, in which systematic inflammation parameters with neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) were significantly changed by palliative radiotherapy on metastatic lymph nodes. The patient achieved persistent response to the re-challenge of immune checkpoint inhibitor, which resulted in survival time reaching 52 months, and is still in extension.ConclusionsWe supposed that the palliative radiotherapy may lead to the correction of NLR, LMR, and PLR and finally contribute to the efficacy of the re-challenge treatment by PD-1 inhibitor.

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Low cardiac dose and neutrophil-to-lymphocyte ratio predict overall survival in inoperable esophageal squamous cell cancer patients after chemoradiotherapy

Cited by 6 publications

References 53 publications

The predictive value of peripheral blood cells and lymphocyte subsets in oesophageal squamous cell cancer patients with neoadjuvant chemoradiotherapy

The predictive value of peripheral blood cells and lymphocyte subsets in oesophageal squamous cell cancer patients with neoadjuvant chemoradiotherapy

Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve

Changes in Neutrophil to Lymphocyte Ratio, Lymphocyte to Monocyte Ratio, and Platelet to Lymphocyte Ratio During Palliative Radiotherapy May Predict Efficacy of Immune Checkpoint Inhibitor as Re-Challenge Treatment in Advanced Gastric Cancer: A Case Report

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