Analysis of neutrophil-lymphocyte ratio as a prognostic element in the response to neoadjuvant therapy in rectal cancer

INTRODUCTION: The previous radio-chemotherapy approach is highly relevant in the management of rectal cancer, collaborating on organ functional preservation, being performed prior to surgery. The inflammatory response plays an important role in this treatment. OBJECTIVE: It consists in correlating the number of peripheral lymphocytes and the neutrophil/lymphocyte ratio in the peripheral blood with tumor response to neoadjuvant therapy. METHODS: Review of medical records of patients with rectal cancer in HMSJ and HSJ Oncology Services since 2009 - cases submitted to neoadjuvant treatment with radio-chemotherapy. RESULTS: Of those 96 patients with this disease who underwent neoadjuvant therapy with radio-chemotherapy, 35 patients were eligible; complete tumor response was observed in 11 cases (31%), and 9 were submitted to surgical treatment. Comparing the leukocyte parameters between patients with complete response (CR) and incomplete response (IR) the following values were observed: total number of leukocytes (mean) CR 7390.9 × IR 7220.4 (p = 0.8); total lymphocytes CR 2103 × IR 1960.9 (p = 0.4); neutrophil/lymphocyte ratio CR 3.55 × IR 3.79 (p = 0.5). The mean radiotherapy dose was 49.1 Gy, with CR 47.3 × IR 50.0 (p = 0.06). CONCLUSION: It was not possible to demonstrate in this study a significant relationship between complete tumor response to neoadjuvant therapy with respect to blood leukocyte parameters analyzed