en Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: In this study, we explored the relationship between&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; neutrophil-to-lymphocyte ratio (NLR) and grade 3 or higher treatment related small bowel toxicity and treatment outcome of patients with rectal cancer undergoing capecitabine and concurrent intensity modulated radiotherapy (IMRT). Materials and Methods: From the year of 2012 to 2013, 117 rectal cancer patients who received concurrent chemoradiotherapy in our hospital were enrolled in this study. The association of baseline NLR level with grade 3 or higher treatment related small bowel toxicity and treatment outcome, including overall survival (OS) and progression free survival (PFS) were analyzed.&nbsp; Results: The optimal cut-off value of the NLR was determined to be 2.2 for the OS according to the receiver operating characteristic (ROC) analysis. A higher level of the baseline NLR was associated with hypoalbuminemia (P= 0.018). No relationship between NLR level and grade 3 or higher acute as well as late treatment related small bowel toxicity was found. A multivariate Cox model revealed that lymph node metastasis (p= 0.013), distant metastasis (p< 0.001), and high NLR level (p = 0.032) were significant predictors for poor OS. Nevertheless, a relationship between NLR level and PFS was not found. Conclusion: This study show that higher baseline NLR level could not predict treatment related small bowel toxicity of rectal cancer patients who received capecitabine and concurrent IMRT. It is very gratifying to see that NLR is a useful predictor for treatment outcome of these patients.</div> Neutrophil-to-lymphocyte ratio (NLR), rectal cancer, small Bowel toxicity, prognosis. 309 315 http://ijrr.com/browse.php?a_code=A-10-1-786&slc_lang=en&sid=1 X.H. Bai 7900319475328460013074 7900319475328460013074 No Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China G.L. Zou 7900319475328460013075 7900319475328460013075 No Graduated School, Ningxia Medical University, Yinchuan 750004, Ningxia, China Z. Ding 7900319475328460013076 7900319475328460013076 No Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China R. Zhao 7900319475328460013077 7900319475328460013077 No Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China H. Zhe 7900319475328460013078 7900319475328460013078 No Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China Y.Y. Wang fdwyy1981@hotmail.com 7900319475328460013079 7900319475328460013079 No Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China