Trial reportRadiation oncology (London, England)2019
Clinical predictors of radiation-induced lymphopenia in patients receiving chemoradiation for glioblastoma: clinical usefulness of intensity-modulated radiotherapy in the immuno-oncology era.
Trial report in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 63 citations in OpenAlex.
- Brain dose burden is associated with treatment-related lymphopenia in IDH-wildtype glioblastoma: dosimetric determinants and prognostic impact.Journal of neuro-oncology · 2026Article
- No Evidence for Depletion of Circulating Lymphocyte Populations in Primary Brain Tumor Patients Receiving Radiation Therapy Alone.International journal of radiation oncology, biology, physics · 2026Article
- Article
- Real-world survival and prognostic factors in WHO 2021 classified gliomas treated with chemo-radiotherapy.Scientific reports · 2025Article
- Assessment of prognostic value and development of predictive model for prolonged lymphopenia in patients with glioblastoma following chemoradiotherapy.Journal of radiation research · 2025Article
- Combined inflammation-related biomarkers and clinicopathological features for the prognosis of stage II/III colorectal cancer by machine learning.BMC cancer · 2024Article
- Methylation cytometric pretreatment blood immune profiles with tumor mutation burden as prognostic indicators for survival outcomes in head and neck cancer patients on anti-PD-1 therapy.NPJ precision oncology · 2024Article
- Lymphopenia associated with whole-brain radiotherapy and its effects on clinical outcomes of patients with brain metastases.Scientific reports · 2024Article
- Radiation-Induced Lymphopenia and Its Impact on Survival in Patients with Brain Metastasis.Current oncology (Toronto, Ont.) · 2024Article
- Nomogram for radiation-induced lymphopenia in patients receiving intensity-modulated radiotherapy based-chemoradiation therapy for newly diagnosed glioblastoma: A multi-institutional study.Clinical and translational radiation oncology · 2024Article
- Efficacy of Shenglin decoction in preventing acute severe lymphocytopenia in patients with non-small cell lung cancer undergoing concurrent chemoradiotherapy: a study protocol for a randomized controlled trial.Frontiers in oncology · 2024Article
- The need for paradigm shift: prognostic significance and implications of standard therapy-related systemic immunosuppression in glioblastoma for immunotherapy and oncolytic virotherapy.Frontiers in immunology · 2024Review
- Impact of boost sequence in concurrent chemo-radiotherapy on newly diagnosed IDH-wildtype glioblastoma multiforme.Journal of neuro-oncology · 2023Article
- Developing the POTOMAC Model: A Novel Prediction Model to Study the Impact of Lymphopenia Kinetics on Survival Outcomes in Head and Neck Cancer Via an Ensemble Tree-Based Machine Learning Approach.JCO clinical cancer informatics · 2023Article
- Impact of radiation on immune cells in patients with low-grade brain tumor: Identifying critical factors affecting lymphopenia and neutrophil-to-lymphocyte ratio.Radiation oncology journal · 2023Article
- Clinical Outcomes of Moderately Hypofractionated Concurrent Chemoradiotherapy for Newly Diagnosed Glioblastoma.Yonsei medical journal · 2023Article
- Reduced radiation exposure to circulating blood cells in proton therapy compared with X-ray therapy in locally advanced lung cancer: Computational simulation based on circulating blood cells.Frontiers in oncology · 2023Article
- A Systematic Review and Meta-analysis of the Impact of Radiation-Related Lymphopenia on Outcomes in High-Grade Gliomas.South Asian journal of cancer · 2022Article
- Cell-based immunotherapy of glioblastoma multiforme.Oncology letters · 2022Review
- A dynamic blood flow model to compute absorbed dose to circulating blood and lymphocytes in liver external beam radiotherapy.Physics in medicine and biology · 2022Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundImmunotherapy is currently being examined as a treatment modality for glioblastoma. Maintaining an optimal total lymphocyte count (TLC) after radiotherapy (RT) and using temozolomide may be beneficial in optimizing immunotherapy. However, conventional temozolomide-based chemoradiation is known to induce immunosuppressive effects, including lymphopenia. Therefore, this study aimed to identify potential clinical predictors of acute severe lymphopenia (ASL) in patients receiving chemoradiation for glioblastoma.
methodsWe identified patients with glioblastoma treated with RT plus temozolomide from 2006 to 2017. ASL was defined as a TLC of < 500/μL within 3 months after initiating RT. Independent predictors of ASL were determined using logistic regression.
resultsA total of 336 patients were evaluated. Three-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) were used in 186 (55.4%) and 150 patients (44.6%), respectively. TLC decreased during RT and remained persistently low during the 1-year follow-up, whereas the levels of other blood cell types recovered. In total, 118 patients (35.1%) developed ASL. During a median follow-up of 19.3 months, patients with ASL showed significantly worse overall survival than did those without ASL (median, 18.2 vs. 22.0 months; P = .028). Multivariable analysis revealed that increased planning target volume (PTV) was independently associated with increased ASL incidence (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.00-1.03; P = .042), while IMRT was independently associated with decreased ASL incidence (HR, 0.48; 95% CI, 0.27-0.87; P = .015). A propensity-matched comparison showed that the incidence of ASL was lower with IMRT than with 3D-CRT (20% vs. 37%; P = .005).
conclusionsIMRT and low PTV were significantly associated with decreased ASL incidence after RT plus temozolomide for glioblastoma. An IMRT-based strategy is necessary to enhance treatment outcomes in the immune-oncology era.
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