Background:The literature is inconsistent for the role of neutrophil-to-lymphocyte ratio (NLR) obtained before neoadjuvant therapy (pre-NLR) in predicting pathological response to neoadjuvant chemoradiation (neoCRT) in patients with locally advanced rectal cancer (LARC). In the present cohort study, we explored the predictive role of pre-NLR in this setting. Methods: We prospectively included patients with LARC who were candidates for neoCRT at the Shohada-e-Hafte Tir Hospital (Tehran, Iran) between Mar 2018 and Feb 2020. The pre-NLR was obtained through a peripheral blood smear before CRT. We used the AJCC system for evaluating tumor regression grade (TRG). The TRGs were categorized into: response-group 1 (TRG 0-1 vs. 2-3), response-group 2 (TRG 0 vs. 1-3), and responsegroup 3 (TRG 0-2 vs. 3). We applied receiver operating characteristic (ROC) analysis to assess the predictive value of pre-NLR. Results: Of the 86 screened patients with rectal cancer, 30 patients who fulfilled the inclusion criteria were included in the study. In total, 63.3% were responsive, and 23.3% had complete pathologic response. Pre-NLR could not predict the pathologic response in response-group 1 (area under the ROC curve [AUC]: 0.45, 95%CI 0.23-0.66) and response-group 2 (AUC: 0.36, 95%CI 0.13-0.59). Nevertheless, it had a poor predictive value in response-group 3 (AUC: 0.55, CI%95 0.33-0.75) with an optimal NLR cutoff value of 2.94. Conclusions: Pre-NLR could not predict the pathological response to neoCRT in our cohort of patients with LARC.

To investigate whether excision repair cross complementing-group1 (ERCC1) expression status could serve as a bio-predictor of response to platinum-based induction chemotherapy for head and neck cancers (HNCs) patients with a diagnosis of epithelial HNC were studied retrospectively. Paraffin embedded tumor samples of the patients were analyzed by reverse transcription-polymerase chain reaction (RT-PCR) to determine ERCC1 expression status and its correlation with response to platinum-based induction chemotherapy was investigated. Of 44 included patients, 33 were male (75%) and 11 were female (25%) with a mean age of 53 years. Some 36% of patients whose tumor samples had high ERCC1 expression showed no response to induction chemotherapy. The value for patients with low ERCC1 expression was 9% and the difference was statistically significant (p=0.03). The ERCC1 expression state did not significantly vary between patient groups according to sex, age, primary tumor site, and tumor and node stage. Our study indicates that ERCC1 expression status detected by RT-PCR might serve as a bio-predictor of response to platinum-based induction chemotherapy for epithelial HNCs.

Background: Serum creatinine level is frequently used as a measure for renal function assessment. However, there are some situations in which patients may suffer significant renal impairment but serum creatinine levels remain within normal ranges. Objectives: We conducted this study to evaluate the discrepancy between serum creatinine (SCr) level and glomerular filtration rate (GFR) in determining the eligibility for cisplatin-based chemotherapy among cancer patients. Patients and Methods: A total of 198 cancer patients had received cisplatin-based chemotherapy at Jorjani Cancer Center, Emam Hossein Hospital, Tehran, Iran were retrospectively investigated. The discordance between SCr level and calculated GFR by Cockcroft-Gault equation was analyzed. Results: 130 patients (66%) were men and 68 (34%) were women with mean age of 54.5 years. Squamous cell carcinoma (SCC) and head and neck were the most common primary tumor histology and site respectively. Of 165 patients with available data to calculate eGFR, 45 (27.3%) had normal kidney function based solely on SCr levels, but their GFR was less than 60 mL/min (renal dysfunction). The discordance between SCr and GC calculated GFR values were most pronounced in the older age, transitional cell carcinoma histology and bladder primary site. Conclusions: This study shows that SCr level alone may not be a reliable measure of normal kidney function to determine eligibility for cisplatine-based chemotherapy.

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