Evidence map›Paper›PMID 26867885›Full record

Trial reportInternational journal of radiation oncology, biology, physics2016

Lymphocyte-Sparing Effect of Stereotactic Body Radiation Therapy in Patients With Unresectable Pancreatic Cancer.

Aaron T Wild, Joseph M Herman, Avani S Dholakia, Shalini Moningi, Yao Lu, Lauren M Rosati, Amy Hacker-Prietz, Ryan K Assadi, Ali M Saeed, Timothy M Pawlik and 9 more

Registry-linked trialOpen access · greenAbstract readClinical Trial, Phase IIComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of radiation oncology, biology, physics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07052669 (Hypofractionated Chemoradiotherapy Followed by Consolidative Immunotherapy Versus Conventional Fractionated Chemoradiotherapy Followed by Consolidative Immunotherapy in Locally Advanced Non-small Cell Lung Cancer), which is not on this map. Cited by 139 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 5 pooled it
5.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

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.

2 · The registry

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.

NCT07052669 phase3recruitingnot on this mapstarted 2025, after this paper: background citation

Hypofractionated Chemoradiotherapy Followed by Consolidative Immunotherapy Versus Conventional Fractionated Chemoradiotherapy Followed by Consolidative Immunotherapy in Locally Advanced Non-small Cell Lung Cancer: A Randomized, Phase III Controlled Study

TypeinterventionalSponsorSun Yat-sen UniversityRan2025 to 2029Enrolled311ConditionsLocally Advanced Non-Small Cell Lung CancerArmsHypofractionated Radiation Therapy, Conventionally Fractionated Radiation Therapy, Concurrent Chemotherapy, concurrent chemotherapy, Consolidative immunotherapy
3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 5 syntheses or guidelines pooled it, 228 citations in OpenAlex.

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79 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 4 institutions in 1 country.

Aaron T WildDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
Joseph M HermanDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Avani S DholakiaDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Shalini MoningiDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Yao LuDepartment of Oncology Biostatistics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Lauren M RosatiDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Amy Hacker-PrietzDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ryan K AssadiDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ali M SaeedDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Timothy M PawlikDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Elizabeth M JaffeeDepartment of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Daniel A LaheruDepartment of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Phuoc T TranDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Matthew J WeissDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Christopher L WolfgangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Eric FordDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington.
Stuart A GrossmanDepartment of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Xiaobu YeDepartment of Oncology Biostatistics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Susannah G EllsworthDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: sbatkoy2@jhmi.edu.
Johns Hopkins Medicine · USJohns Hopkins University · USMemorial Sloan Kettering Cancer Center · USUniversity of Washington · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Translational Research Central ServicesP30CA006973 · NCI · JOHNS HOPKINS UNIVERSITY · PI Rosalie Wollett · 1985 to 2026
$208.6M
Targeting the Immunosuppressive Tumor Microenvironment of Pancreatic Cancer with a Neoadjuvant Platform Clinical TrialR01CA197296 · NCI · JOHNS HOPKINS UNIVERSITY · PI William Reece Burns, Eric Christenson · 2015 to 2026
$5.7M
Structure-Functions Studies of Twist1-induced Radioresistance in Lung CancerR01CA166348 · NCI · JOHNS HOPKINS UNIVERSITY · PI TRAN, PHUOC T. · 2013 to 2017
$1.7M
NCI NIH HHS P30 CA006973NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA166348NCI NIH HHS R01 CA197296
6 · The paper itself

Abstract

purposeRadiation-induced lymphopenia (RIL) is associated with inferior survival in patients with glioblastoma, lung cancer, and pancreatic cancer. We asked whether stereotactic body radiation therapy (SBRT) decreases severity of RIL compared to conventional chemoradiation therapy (CRT) in locally advanced pancreatic cancer (LAPC). METHODS AND MATERIALS: Serial total lymphocyte counts (TLCs) from patients enrolled in a prospective trial of SBRT for LAPC were compared to TLCs from an existing database of LAPC patients undergoing definitive CRT. SBRT patients received 33 Gy (6.6 Gy × 5 fractions). CRT patients received a median dose of 50.4 Gy (1.8 Gy × 28 fractions) with concurrent 5-fluorouracil (77%) or gemcitabine (23%) therapy. Univariate and multivariate analyses (MVA) were used to identify associations between clinical factors and post-treatment TLC and between TLC and survival.

resultsThirty-two patients received SBRT and 101 received CRT. Median planning target volume (PTV) was smaller in SBRT (88.7 cm(3)) than in CRT (344.6 cm(3); P<.001); median tumor diameter was larger for SBRT (4.6 cm) than for CRT (3.6 cm; P=.01). SBRT and CRT groups had similar median baseline TLCs. One month after starting radiation, 71.7% of CRT patients had severe lymphopenia (ie, TLC <500 cells/mm(3) vs 13.8% of SBRT patients; P<.001). At 2 months, 46.0% of CRT patients remained severely lymphopenic compared with 13.6% of SBRT patients (P=.007). MVA demonstrated that treatment technique and baseline TLCs were significantly associated with post-treatment TLC at 1 but not 2 months after treatment. Higher post-treatment TLC was associated with improved survival regardless of treatment technique (hazard ratio [HR] for death: 2.059; 95% confidence interval: 1.310-3.237; P=.002).

conclusionsSBRT is associated with significantly less severe RIL than CRT at 1 month in LAPC, suggesting that radiation technique affects RIL and supporting previous modeling studies. Given the association of severe RIL with survival in LAPC, further study of the effect of radiation technique on immune status is warranted.

Indexed as

AdenocarcinomaAgedAntimetabolites, AntineoplasticChemoradiotherapyDeoxycytidineDose Fractionation, RadiationFemaleFluorouracilGemcitabineHumansLymphocyte CountLymphopeniaMaleMiddle AgedPancreatic NeoplasmsProspective StudiesAntimetabolites, AntineoplasticDeoxycytidineFluorouracilGemcitabine

Identifiers

PMID26867885
PMCPMC4847529
OpenAlexW2183674768

What OpenQuestion holds

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Read underepoch 390

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.