# Pre-treatment blood parameters as an economical predictive marker for predicting treatment response in locally advanced cervical cancer

## TL;DR

This study explores how blood parameters before treatment can predict outcomes in cervical cancer patients, offering a cost-effective approach for treatment planning.

## Contribution

The study identifies specific pre-treatment blood markers that predict treatment response in locally advanced cervical cancer.

## Key findings

- Non-responders had higher hemoglobin, NLR, and EAR, and lower PNI compared to responders.
- ROC analysis determined optimal cut-off values for hemoglobin (<9.5), NLR (<2.98), PLR (>289.26), PNI (<37.67), and EAR (<49.63).
- Blood parameters could aid in treatment planning and improve patient outcomes in cervical cancer.

## Abstract

Cervical cancer poses a significant public health challenge, particularly in low and middle-income countries. Despite advancements in treatment, the disease remains a leading cause of cancer-related deaths among women globally. Chemoradiation utilizing cisplatin has been the cornerstone therapy for locally advanced cervical cancer. Prognostic biomarkers, including hematological parameters, have emerged as valuable tools in guiding treatment decisions and predicting outcomes.

Data from patients treated between January 2021 and June 2022 were analyzed. Demographic information, histopathology, pre-treatment blood parameters, treatment details, and response assessments were collected. The parameters assessed included hemoglobin levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and eosinophil albumin ratio (EAR). Receiver operating characteristic (ROC) curve analysis was conducted to determine optimal cut-off values for these biomarkers.

Of the 140 patients included, the majority had squamous cell carcinoma (92%) and were at stage II or III. Complete response to treatment was observed in 86.4% of patients. Non-responders demonstrated significantly higher levels of hemoglobin, NLR, and EAR, along with lower PNI levels compared to responders. ROC analysis revealed cut-off values for hemoglobin (< 9.5), NLR (< 2.98), PLR (> 289.26), PNI (< 37.67), and EAR (< 49.63) associated with treatment response.

The study highlights the potential utility of pre-treatment blood parameters as predictive markers for treatment response in locally advanced cervical cancer. Lower hemoglobin, higher NLR, and EAR, along with reduced PNI, were associated with poorer treatment outcomes. Integration of these biomarkers into clinical practice could aid in treatment planning and improve patient outcomes. Further validation and prospective studies are warranted to establish the role of these biomarkers in guiding personalized treatment strategies for cervical cancer patients.