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Peer-reviewedCC BY 4.0Cancers

Associations of Pretreatment Hemoglobin, Body Mass Index, and Leukocyte Count with Acute and Late Toxicity During and After Radiotherapy for Rectal Cancer

  • Nouf M. Alzahrani1
  • Alhanouf Alalyani1
  • Raghad Almutairi1
  • Hussam Hijazi2
  • Farag Shuweihdi3,4
  • Lojain Abdulaal1
  • Bashair Alhummiany5
  • Naglaa Elsayed1,6
  • Awad Alzahrani1
  • Meshal Alzahrani1
  • Nasser M. Alzahrani1
  • Lamyaa Aljaafari7,8
2 more authors
  • Hanan M. Alzahrani5
  • Omar Iskanderani2
8 affiliations
  1. 1Department of Radiological Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
  2. 2Department of Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
  3. 3Faculty of Health and Life Sciences, University of Leeds, Leeds LS2 9JT, UK
  4. 4Libyan Authority for Scientific Research, Tripoli, Libya
  5. 5Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia
  6. 6Diagnostic Radiology Department, Faculty of Medicine, Cairo University, Cairo 11956, Egypt
  7. 7Department of Radiology and Medical Imaging, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Ahsa 31982, Saudi Arabia
  8. 8King Abdullah International Medical Research Center, Al Ahsa 31982, Saudi Arabia
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Abstract

Background/Objectives: Radiotherapy is an important component of rectal cancer treatment, but treatment-related toxicity varies considerably between patients, suggesting that patient-related factors may influence susceptibility. Pretreatment hemoglobin, leukocyte count, and body mass index (BMI) are routinely available measures, yet their associations with acute and late toxicity during and after radiotherapy remain unclear. This study evaluated these associations in patients with rectal cancer. Methods: A retrospective analysis included 67 patients with histologically confirmed rectal cancer who underwent radiotherapy. Acute toxicity occurred during radiotherapy or within 3 months after treatment completion, and late toxicity occurred thereafter. Toxicity was graded using the Common Terminology Criteria for Adverse Events (CTCAE) and dichotomized as Grades 0–1 or Grade ≥ 2. Pretreatment hemoglobin, total leukocyte count, and BMI were analyzed as continuous variables. Logistic regression examined associations with acute and late toxicity, with sequential adjustment for age, sex, and radiotherapy course. Results: Grade ≥ 2 acute toxicity occurred in 17 patients (25.4%), and Grade ≥ 2 late toxicity in 27 (40.3%). Higher pretreatment leukocyte count was associated with greater odds of acute toxicity in the fully adjusted model (OR 1.70, 95% CI 1.13–2.58; p = 0.012). Higher pretreatment hemoglobin was associated with lower odds of late toxicity in the fully adjusted model (OR 0.57, 95% CI 0.40–0.81; p = 0.002). No clear association was observed between BMI and either acute or late toxicity. Conclusions: Pretreatment leukocyte count was associated with acute toxicity, while pretreatment hemoglobin was associated with late toxicity. These inexpensive, routinely available measures may represent candidate markers of toxicity, although their clinical utility requires validation in larger, independent studies.

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Cite

BibTeXRIS
BibTeX
@article{alzahrani2026associations,
  title = {{Associations of Pretreatment Hemoglobin, Body Mass Index, and Leukocyte Count with Acute and Late Toxicity During and After Radiotherapy for Rectal Cancer}},
  author = {Nouf M. Alzahrani and Alhanouf Alalyani and Raghad Almutairi and Hussam Hijazi and Farag Shuweihdi and Lojain Abdulaal and Bashair Alhummiany and Naglaa Elsayed and Awad Alzahrani and Meshal Alzahrani and Nasser M. Alzahrani and Lamyaa Aljaafari and Hanan M. Alzahrani and Omar Iskanderani},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18213475},
  url = {https://www.mdpi.com/2072-6694/18/21/3475},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Associations of Pretreatment Hemoglobin, Body Mass Index, and Leukocyte Count with Acute and Late Toxicity During and After Radiotherapy for Rectal Cancer
AU  - Nouf M. Alzahrani
AU  - Alhanouf Alalyani
AU  - Raghad Almutairi
AU  - Hussam Hijazi
AU  - Farag Shuweihdi
AU  - Lojain Abdulaal
AU  - Bashair Alhummiany
AU  - Naglaa Elsayed
AU  - Awad Alzahrani
AU  - Meshal Alzahrani
AU  - Nasser M. Alzahrani
AU  - Lamyaa Aljaafari
AU  - Hanan M. Alzahrani
AU  - Omar Iskanderani
PY  - 2026
DA  - 2026/10/28
JO  - Cancers
DO  - 10.3390/cancers18213475
UR  - https://www.mdpi.com/2072-6694/18/21/3475
AB  - Background/Objectives: Radiotherapy is an important component of rectal cancer treatment, but treatment-related toxicity varies considerably between patients, suggesting that patient-related factors may influence susceptibility. Pretreatment hemoglobin, leukocyte count, and body mass index (BMI) are routinely available measures, yet their associations with acute and late toxicity during and after radiotherapy remain unclear. This study evaluated these associations in patients with rectal cancer. Methods: A retrospective analysis included 67 patients with histologically confirmed rectal cancer who underwent radiotherapy. Acute toxicity occurred during radiotherapy or within 3 months after treatment completion, and late toxicity occurred thereafter. Toxicity was graded using the Common Terminology Criteria for Adverse Events (CTCAE) and dichotomized as Grades 0–1 or Grade ≥ 2. Pretreatment hemoglobin, total leukocyte count, and BMI were analyzed as continuous variables. Logistic regression examined associations with acute and late toxicity, with sequential adjustment for age, sex, and radiotherapy course. Results: Grade ≥ 2 acute toxicity occurred in 17 patients (25.4%), and Grade ≥ 2 late toxicity in 27 (40.3%). Higher pretreatment leukocyte count was associated with greater odds of acute toxicity in the fully adjusted model (OR 1.70, 95% CI 1.13–2.58; p = 0.012). Higher pretreatment hemoglobin was associated with lower odds of late toxicity in the fully adjusted model (OR 0.57, 95% CI 0.40–0.81; p = 0.002). No clear association was observed between BMI and either acute or late toxicity. Conclusions: Pretreatment leukocyte count was associated with acute toxicity, while pretreatment hemoglobin was associated with late toxicity. These inexpensive, routinely available measures may represent candidate markers of toxicity, although their clinical utility requires validation in larger, independent studies.
SN  - 2072-6694
ER  -