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The relationship between the lowest value of neutrophil and lymphocyte and the therapeutic effect and prognosis of synchronous chemoradiotherapy in elderly patients with cervical cancer

Kang Wanying;Wang Yu;Zhang Linlin;Liu Yuping;Niu Leilei;Department of Radiotherapy, Tumor Hospital of Fuyang City;  
Objective To explore the relationship between the lowest values of neutrophil(N) and lymphocyte(L) and the therapeutic effect and overall survival(OS) in elderly patients with cervical cancer during synchronous chemoradiotherapy, and provide a basis for the diagnosis, treatment and prognosis evaluation of cervical cancer. Methods A total of 116 elderly patients with cervical cancer who underwent synchronous chemoradiotherapy in Cancer Hospital of Fuyang City from January 2017 to December 2019 were selected as the research subjects. Their clinical data were analyzed retrospectively. The clinical data of patients were collected and all patients were followed up. The end point of follow-up was all-cause death. The OS of the patients was determined by the Kaplan-Meier curve, and the Log-rank test was performed. Univariate and multivariate Cox regression analysis was used to identify independent risk factors for OS. Results The receiver operating characteristic curve suggested that the cut-off values for the lowest values of N and L were 1.69×10~9/L and 0.52×10~9/L, respectively. The effective rate of the N lowest value1.69×10~9/L group was significantly lower than that of the N lowest value≤1.69×10~9/L group(P=0.04). The median follow-up time of the patients was 43 months, and 48 patients(41.37%) reached the end point of follow-up. The 3-year survival rates in the N lowest value1.69×10~9/L group and the L lowest value≤0.52×10~9/L group were significantly lower than those in the N lowest value≤1.69×10~9/L group and the L lowest value0.52×10~9/L group, respectively(66.8% vs 89.2%, P0.001; 62.0% vs 87.7%, P0.001). Cox multivariate regression confirmed that the N lowest value1.69×10~9/L(HR=1.90) and L the lowest value≤0.52×10~9/L(HR=2.21) were independent risk factors for OS. Conclusion During synchronous chemoradiotherapy in elderly patients with cervical cancer, the lowest values of N and L may have opposite prognostic significance. Dynamic monitoring of N and L levels may have certain guiding value for the treatment and prognosis of patients.
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