Nevertheless, several prior reports have described meaningful responses to NAC in locally advanced or initially unresectable ONB, supporting its selective use when downstaging is needed to facilitate complete resection [12-14]. In the present patient, grade 3/4 hematologic toxicities, including neutropenia, anemia, and thrombocytopenia, were observed during NAC; however, these adverse events were appropriately managed with granulocyte colony-stimulating factor support and platelet transfusion, allowing completion of the planned five cycles without delaying the scheduled surgical treatment. Here, CSF3 is linked to Decreased total neutrophil count.