ArticleCancer medicine2026
Comparison of Thrombocytopenia and Splenomegaly in Locally Advanced Rectal Cancer Patients Receiving Total Neoadjuvant Therapy With and Without Immunotherapy.
Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundThrombocytopenia is a common toxicity of oxaliplatin-based chemotherapy and may be linked to hepatic sinusoidal obstruction and splenic enlargement. In the TORCH trial, adding PD-1 blockade to an oxaliplatin-containing total neoadjuvant therapy (TNT) regimen improved tumor response in patients with locally advanced rectal cancer (LARC), but thrombocytopenia appeared more frequent and more severe. Here, we evaluated whether adding PD-1 blockade to TNT increased thrombocytopenia risk and explored its association with hepatic injury and splenomegaly.
methodsWe retrospectively reviewed 181 LARC patients treated at Fudan University Shanghai Cancer Center. The cohort included 44 patients who received long-course chemoradiotherapy (LCRT) followed by oxaliplatin-containing chemotherapy (Ox-TNT), 41 who received LCRT followed by irinotecan-based chemotherapy (Iri-TNT), and 96 who received short-course radiotherapy plus six cycles of CAPOX and toripalimab (iTNT). We collected serial blood test results and measured liver and spleen volumes before and after treatment. Thrombocytopenia was graded according to CTCAE v5.0.
resultsAmong 181 patients, thrombocytopenia occurred in 118 (65.2%), and splenomegaly in 69 (38.1%). Both events were most frequent in iTNT group, with incidences of 83.3% and 61.5%, respectively. Rates were lower in Ox-based TNT group (50.0% and 13.6%) and in Iri-based TNT group (39.0% and 9.8%), respectively. Platelet count showed an inverse correlation with both increased AST level (p < 0.001) and splenic volume (p < 0.001). In multivariate analysis, iTNT (p = 0.002), splenomegaly (p = 0.003), and older age (p = 0.004) were independently associated with G2-4 thrombocytopenia. Factors that independently predicted splenomegaly included iTNT (p < 0.001), direct bilirubin (p = 0.031), hepatomegaly (p = 0.032), and AST (p = 0.032). In the iTNT group, splenomegaly (p = 0.009) and older age (p = 0.033) remained associated with G2-4 thrombocytopenia. Lower CD8
conclusionsPD-1 blockade added to TNT was associated with more severe thrombocytopenia than conventional TNT in LARC patients, possibly through greater hepatic injury and splenomegaly.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.