Kemoradyoterapi Uygulanan Hastalarda İnflamatuvar İndeksler ile Tümör Volüm Değişiminin İlişkisi

Yıl 2021, Cilt 2, Sayı 1, 23 - 28, 06.03.2021

İsmail BEYPINAR Fuzuli TUĞRUL

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

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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