FIGURE 1.
Dose distribution of volumetric modulated arc therapy with simultaneous integrated boost in a representative patient with locally advanced rectal cancer undergoing total neoadjuvant treatment. Bone marrow contour is in yellow. (A) Axial view. (B) Sagittal view.
TABLE 1.
Patient, lymphocyte count and dosimetric characteristics
| Induction chemotherapy | Consolidation chemotherapy | |
|---|---|---|
| Number of patients | 28 | 25 |
| Sex | 25 M, 3 F | 20 M, 5 F |
| Mean age at the start of treatment (years) | 59.1 (37-76) | 54.3 (33-72) |
| Mean absolute lymphocyte count at the start of treatment | 2.13 × 109/L (0.78 IQR) | 1.95 × 109/L (1.03 IQR) |
| Mean absolute lymphocyte count at the end of treatment | 1.12 × 109/L (0.52 IQR) | 0.92 × 109/L (0.37 IQR) |
| Mean change in lymphocyte count | -1.05 × 109/L (0.77 IQR) | -1.10 × 109/L (1.02 IQR) |
| Number of patients with RIL | 15 (53.6%) | 19 (76.0%) |
| Mean PTV size | 1273 mL (299 IQR) | 1259 mL (378 IQR) |
| Mean pelvic bone marrow volume | 1767 mL (304 IQR) | 1693 mL (362 IQR) |
| Mean dose to pelvic bone marrow | 20.38 Gy (3.04 IQR) | 20.43 Gy (2.16 IQR) |
| V5Gy | 80.23% (8.48 IQR) | 80.26% (8.75 IQR) |
| V10Gy | 71.34% (10.0 IQR) | 69.43% (11.1 IQR) |
| V20Gy | 50.95% (9.1 IQR) | 51.06% (8.6 IQR) |
| V30Gy | 26.65% (8.2 IQR) | 26.56% (6.9 IQR) |
| V40Gy | 10.25% (3.6 IQR) | 10.10% (2.9 IQR) |
| V42Gy | 5.47 % (2.1 IQR) | 4.90% (2.5 IQR) |
TABLE 2.
Neutrophil-to-lymphocyte ratio (NLR) pre- and post-treatment
| Induction chemotherapy | Consolidation chemotherapy | |
|---|---|---|
| Mean absolute neutrophil count at the start of treatment | 5.15 × 109/L (1.94 IQR) | 5.79 × 109/L (2.12 IQR) |
| Mean absolute neutrophil count at the end of treatment | 2.79 × 109/L (0.88 IQR) | 3.03 × 109/L (1.53 IQR) |
| Mean change in neutrophil count | -2.35 × 109/L (1.63 IQR) | -2.76 × 109/L (2.88 IQR) |
| Mean pre-treatment NLR | 2.76 (1.18 IQR) | 3.27 (2.33 IQR) |
| Mean post-treatment NLR | 2.83 (1.64 IQR) | 3.73 (1.49 IQR) |
| Mean change NLR | +0.07 (1.49 IQR) | +0.46 (2.44 IQR) |