Pre-treatment hematological parameters as a cost effective predictive marker for response to concurrent chemo radiation in locally advanced cervical cancer

• Published in: Cancer treatment and research communications 2022, Vol.31, p.100539-100539, Article 100539
• Main Authors: Chauhan, Richa, Trivedi, Vinita, Rani, Reeta, Singh, Usha, Singh, Kanchan
• Format: Article
• Language: English
• Subjects: Cervical cancer; Chemo radiation; Hematological parameters; Response
• ISSN: 2468-2942; 2468-2942
• DOI: 10.1016/j.ctarc.2022.100539

•Locally advanced cervical cancer is still a major cause of mortality and morbidity among female cancer patients of developing countries. Concurrent Cisplatin based chemo radiation has remained the standard of treatment for years.•About 30–40% of the patients show resistance to chemo radiation and progress.•To improve on the results, new treatment protocols using concurrent doublet chemotherapy, induction chemotherapy followed by chemo radiation, adjuvant chemotherapy after chemo radiation, targeted therapy have been used in various trials showing an improvement in local control and overall survival, but with an added cost and toxicities.•Various biomarkers have also been postulated to predict the response to chemo radiation but till date no robust biomarker has been validated for the same.•Cost effective markers like hematological parameters has the potential to be used as predictive biomarkers especially in patients from low socio-economic status. Locally advanced cervical cancer is still a major cause of mortality in developing countries. Recently, personalized medicine has changed the treatment paradigm for many solid cancers but no robust biomarkers has yet been validated for predicting response to chemo radiation in cervical cancer patients. To assess the role of hematological parameters as a cost-effective predictive marker of response to concurrent chemo radiation in cervical cancer patients. This is a retrospective analysis of 90 cervical cancer patients treated with concurrent chemo radiation in a tertiary cancer center. Clinical details of the patients were extracted from the case records. For end point evaluation, the pre-treatment levels of hemoglobin, neutrophil, lymphocyte, platelet, platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) were compared and statistically analyzed between responders and non-responders. The optimal cutoff values of hematological parameters were estimated by the receiver operating characteristics (ROC) curve. Out of 90 patients, 60 (66.66%) were complete responders and remaining 30 (33.33%) were non-responders. The mean value of platelet, NLR, and PLR was significantly higher in the non-responder group. ROC curve analysis showed the optimal cut-off value of pre-treatment Hb, PLT, NLR and PLR to be 11 gm/dl, 3, 177 × 109/L, and 70 respectively. Our study suggests that simple hematological markers like NLR, PLT count and PLR could be used as a cost effective pretreatment predictive marker for respons