Kemoradyoterapi Uygulanan Hastalarda İnflamatuvar İndeksler ile Tümör Volüm Değişiminin İlişkisi

Year 2021, Volume: 2 Issue: 1, 23 - 28, 06.03.2021

İsmail Beypınar , Fuzuli Tuğrul

https://doi.org/10.48176/esmj.2021.11

Abstract

Giriş: Enflamatuar belirteçlerin tümörlerin kemoradyasyon yanıtı
üzerindeki etkisi, birden çok kanser üzerinde çalışılmaktadır. Çok
sayıda çalışma, tümör ilerlemesi ve prognozunun bağışıklık
durumu ve beslenme durumu ile ilişkili olduğunu göstermiştir. Bu
çalışmada farklı kanser tiplerinde, tümör hacmini değişimini
açısından, farklı kanser tiplerinde inflamatuar belirteçler ile
kemoradyasyon yanıtı arasındaki ilişkiyi araştırdık.
Yöntemler: Çalışmaya kanser tanısı yeterli olup eş zamanlı
kemoterapi ve radyoterapi ile tedavi edilen hastalar dahil edildi.
Hasta demografik özellikleri, lenfosit-nötrofil sayıları hemoglobin,
albümin, C-reaktif protein düzeyleri, tümörün patolojik alt tipi,
hastalığın evresi, tedavi modaliteleri, tümör hacimleri,
kemoterapötik ajanlar ve tedavi sonrası kemoradyoterapi
sonuçları kaydedildi.
Bulgular: Çalışmaya toplam 85 hasta dahil edildi. En sık tanılar
akciğer kanserini takiben beyin ve rektal kanserlerdi. En sık eş
zamanlı kemoterapi protokolü kapesitabin idi. Tam remisyon %
24,7 oranında saptanırken, hastaların yüzde altmış yedisinde
kemoradyoterapi sonrası kısmi remisyon görüldü. Tümör boyut
değişimi ile enflamatuar indeksler arasında hiçbir korelasyon
gözlenmedi. Ayrıca, tümör hacmindeki medyan değişiklik nötrofil
lenfosit oranı (NLO) - prognostik beslenme indeksi (PBI) yüksek
ve düşük gruplar arasında farklı değildi.
Sonuç: Bu çalışmada, tümör hacmi değişikliği ile inflamatuar
belirteçler arasında bir ilişki bulunmamıştır. Tümör hacminde
azalma ile bir ilişki olmamakla birlikte, kesin kemoradyoterapi
uygulanan hastalarda NLO prognostik bir belirteç olduğu
sonucuna varılmıştır.

Keywords

Kanser, Prognostik Beslenme İndeksi, Nötrofil Lenfosit Oranı, Prognoz, Kemoradyasyon

Evaluation of the Correlation Between Inflammatory Indices and Tumor Volume in Patients Received Chemoradiation

Abstract

Introduction: The utility of the inflammatory markers on definitive
chemoradiation is worked on multiple cancers. Several studies
had shown that tumor progression and prognosis were associated
with immune status and nutritional condition. In this study, we
aimed to elucidate the relationship between inflammatory markers
and chemoradiation response in multiple cancer types in terms of
tumor volume.
Methods: The patients who had been diagnosed with cancer and
treated with concurrent chemotherapy and radiotherapy were
included in the study. The patient characteristics, lymphocyteneutrophil counts, hemoglobin, albumin and C-reactive protein
levels, pathologic tumor subtype, stage of the disease, treatment
modalities, tumor volumes, chemotherapeutic agents, and
chemoradiotherapy outcome after the treatment were recorded.
Results: A total of 85 patients were enrolled in the study. The
most frequent diagnoses were brain and rectal cancers following
lung carcinomas. The most commonly used concurrent
chemotherapy protocol was capecitabine. Sixty-seven percent of
the patients have partial remission after chemoradiation, and
24.7% had complete remission. No correlations were observed
between the volume reduction and inflammatory indexes. Also,
the median alteration in tumor volume was not different between
neutrophil to lymphocyte ratio (NLR) - prognostic nutritional index
(PNI) high and low groups.
Conclusion: In this study, we found no relationship between
tumor volume alteration and inflammatory markers. Although there
was no association with the tumor volume change, NLR was a
prognostic marker in patients who underwent definitive
chemoradiation.

Keywords

Cancer, Prognostic Nutritional Index, Neutrophil Lymphocyte Ratio, Prognosis, Chemoradiation

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