Neutrophil-lymphocyte ratio (NLR) reflects the balance between pro- and anti-tumor immune activities. We evaluated whether NLR is associated with pathologic tumor response and prognosis in rectal cancer patients that underwent preoperative chemoradiaton therapy (CRT) with surgery. One hundred two patients with rectal cancer that were treated by preoperative CRT followed by surgery were enrolled. A total of 50.4 GY of radiation and 5-FU-based chemotherapy were delivered. An NLR ≥ 3 was considered to be elevated. Pathologic tumor response based on ypTNM stage was categorized into two groups, good response (n = 35, pathologic complete response and ypTNM I) and poor response groups (n = 67, ypTNM II, III, and IV). Twenty-five patients (24.5%) had elevated NLR. Multivariate analysis showed that an elevated CEA level (p = 0.001), larger tumor (p = 0.03), and elevated NLR (p = 0.04) were significant predictors for a poor response. Poor pathological tumor response and elevated NLR were risk factors for cancer-specific and recurrence-free survivals. An elevated NLR before CRT can be used as predictors for poor tumor response and unfavorable prognostic factors. Dominant pro-tumor activities of neutrophils or reduced anti-tumor immune response by lymphocytes, as determined by NLR, may have a impact on poor tumor response and unfavorable prognosis.

To evaluate the necessity of adaptive planning in helical tomotherapy (TOMO) for head and neck cancer in terms of dosimetric influence on the parotid gland. Thirty-one patients underwent curative TOMO for head and neck cancer from April 2006 to April 2007. For each patient, neck diameter was monitored together with body weight at first cervical spine level through mega-voltage computed tomography during the TOMO course. Ten of 31 patients, with significant weight loss (>5%) and/or neck diameter decrease (>10%), were selected for dosimetric analysis, and parotid dose was recalculated at the fourth and last week of TOMO. Xerostomia was estimated by Radiation Therapy Oncology Group criteria. The median dose was 69.96 Gy (range, 54 to 69.96 Gy) and there was no grade 3 or greater complication. Ten patients with significant neck diameter decrease and/or weight loss showed frequent grade 2 acute xerostomia (P=0.02). The volume percentage of daily fractional dose over 0.75 Gy for the parotid gland (V0.75 Gy) increased by 23.6% at the end of TOMO. For patients with significant anatomic contour change; neck diameter decrease (>10%) or weight loss (>5%), adaptive planning using mega-voltage computed tomography can identify dosimetric changes and reduce deleterious side effects such as xerostomia.

Lee IJ, et al. Cancer Res Treat. 2011 Mar;43(1):24-31. http://dx.doi.org/10.4143/crt.2011.43.1.24

Modulated electro-hyperthermia (mEHT) may enhance the tumor response, although the effectiveness of combined neoadjuvant therapy remains unclear. Therefore, we investigated the role of mEHT with ne...