Department of Medical Oncology, CHU Liège, Liège, Belgium.
Department of Obstetrics and Gynaecology, CHU Liège, Belgium.
Cancer Med. 2020 Nov;9(22):8432-8443. doi: 10.1002/cam4.3465. Epub 2020 Sep 20.
Hemoglobin (Hb), white blood cell (WBC), and polymorphonuclear neutrophil (PMN) blood counts may be correlated with outcomes in patients with locally advanced cervical cancer.
Hb, WBC, and PMN counts were measured at diagnosis and during concomitant cisplatin-based chemoradiotherapy (CCRT) in a retrospective sample of 103 patients between 2010 and 2017. Red blood cell (RBC) transfusions were also recorded. The associations between hematological variables and patient overall survival (OS) and recurrence-free survival (RFS) were assessed by Cox regression models.
The 3-year OS and RFS rates were 81.4% and 76.8%, respectively. In addition to tumor size and smoking, OS and RFS were found to be significantly associated with changes in WBC and PMN counts from the first to the last cisplatin cycle. Hb count throughout the treatment and RBC transfusions were not predictive of outcome.
This study found no association between Hb count or RBC transfusions and outcome. The daily practice of maintaining the Hb count above 12 g/dL during CCRT should be weighed against the potential risks of transfusions. Drops in WBC and PMN counts during treatment positively impacted OS and RFS and could, therefore, serve as biomarkers during CCRT to adapt the follow-up and consider the need for adjuvant systemic treatments.
血红蛋白（Hb）、白细胞（WBC）和中性粒细胞（PMN）计数可能与局部晚期宫颈癌患者的预后相关。
回顾性分析了 2010 年至 2017 年期间 103 例患者的诊断时和同期顺铂为基础的放化疗（CCRT）期间的 Hb、WBC 和 PMN 计数，同时还记录了红细胞（RBC）输注情况。通过 Cox 回归模型评估了血液学变量与患者总生存（OS）和无复发生存（RFS）之间的相关性。
3 年 OS 和 RFS 率分别为 81.4%和 76.8%。除了肿瘤大小和吸烟外，OS 和 RFS 还与从第一个到最后一个顺铂周期的 WBC 和 PMN 计数变化显著相关。治疗期间的 Hb 计数和 RBC 输注与结果无关。
本研究未发现 Hb 计数或 RBC 输注与结局之间存在关联。在 CCRT 期间维持 Hb 计数高于 12g/dL 的日常实践应权衡输血的潜在风险。治疗期间 WBC 和 PMN 计数的下降对 OS 和 RFS 有积极影响，因此可作为 CCRT 期间的生物标志物，以调整随访并考虑是否需要辅助全身治疗。
