Wardhana, Adhitya Angga and Lesmana, Tomy (2021) Neutrophil Lymphocyte Ratio as Predictive Factor Radiological Response of Neoadjuvant Chemotherapy In Locally Advanced Rectal Cancer. Neutrophil Lymphocyte Ratio as Predictive Factor Radiological Response of Neoadjuvant Chemotherapy in Locally Advanced Rectal Cancer, 10 (2). (Submitted)

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Abstract

Abstract Background: Resistance of neoadjuvant chemotherapy (NAC) in locally advanced rectal cancer (LARC) makes patient lose their therapeutic window for tumor resection oncologically. Neutrophil lymphocyte ratio (NLR) as one of inflammatory biomarkers has described in tumor progression. It is aimed that NLR can be as predictive factor for NAC response. Method: This study used a cross-sectional study to assess correlation pre chemotherapy NLR with NAC response, with all subjects were LARC patients who underwent NAC FOLFOX regiment at the Dr. Soetomo Hospital from January 2016 to December 2020. Result: A total of 102 LARC patients underwent NAC. There were 62 (60.8%) patients with low pre chemotherapy NLR (<2.15) and 40 (39.2%) patients with high pre chemotherapy NLR (> 2.15). There were 57 patients with a positive response to NAC (Complete Response/Partial Response) with 48 (84.2%) low NLR; 9 patients (15.8%) have high NLR. There were 45 patients with negative NAC response (Stable Disease/Progressive Disease), 14 (31.1%) patients have low NLR; 31 (68.9%) patients with high NLR. From Chi-square test, it was found that a significant related between pre chemotherapy NLR and radiological response of NAC (p<0.001; OR 11,810; 95% CI). Type of histopathology was significantly related to NAC response (p <0.001; OR 11.810; 95% CI), which by a logistic regression test that the OR value increased to 13 (p <0.001; OR 13,649; 95% CI). Conclusion: Pre chemotherapy NLR can be used, as one of the predictive factors radiological response after NAC FOLFOX regiment in LARC patients. Keywords: neutrophil, lymphocyte, NLR, chemotherapy, LARC

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