P20 Lymphocytes count at diagnosis is a potential survival predictor in patients treated by chemoradiation in locally advanced cervical cancer

Introduction/Background Cancer-mediated inflammation and immunosuppression together with concomitant chemoradiation (CCRT) affects the hematological profile of patients treated for locally advanced cervical cancer (LACC). We investigated the predictive value of a low hemoglobin (Hb) and lymphocytes counts on the outcome of patients receiving CCRT for advanced cervical neoplasia. Methodology Between January 2010 and May 2017, 134 consecutive patients with LACC (FIGO 2009, stages IB2-IVA), received CCRT at the CHU of Liege (Belgium). The data were reviewed retrospectively. Detailed hematological parameters, at initiation (week1) and during CCRT (week ≥2) were collected. Cox univariate analysis measured the impact of Hb and lymphocytes variations on patients recurrence-free-survival (RFS) and cancer-specific-survival (CSS). Results Median follow-up was 37.5 months. Twenty five patients developed recurrence of whom 20 died from the disease. The mCSS is 69.7 months and mRFS is 36.7 months. Hemoglobin level at diagnosis (p=0.67) (HR=1.046-IC=0.850–1.288) or during treatment (p=0.96) (HR=0.989-IC=0.640–1.528) does not affect survival. With a p value of 0,077 and a HR of 0.417 (IC=0.158–1.100) absolute lymphocyte count at week1 demonstrates a borderline significance on CSS. We also demonstrate the same trend with percentage of lymphocytes with a p=0.060 and a HR of 0.952-IC=0.906–1.001. Conclusion Lymphocytes count at initiation of CCRT could be an attractive prognostic factor for patients treated for LACC. In the era of immunotherapy, it could be considered as a potential biomarker for selecting patients benefiting from a combination of radiotherapy and immunotherapy (checkpoint inhibitors). Disclosure Nothing to disclose.