ArticleClinical and translational radiation oncology2020
Radiotherapy-related lymphopenia in patients with advanced non-small cell lung cancer receiving palliative radiotherapy.
Article in Clinical and translational radiation oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Synergies between radiotherapy and immunotherapy: a systematic review from mechanism to clinical application.Frontiers in immunology · 2025Pooled it
- Normal tissue complication probability modeling of severe radiation-induced lymphopenia using blood dose for lung cancer patients treated with IMRT and IMPT.Frontiers in immunology · 2026Article
- Defining the Optimal Radiation-induced Lymphopenia Metric to Discern Its Survival Impact in Esophageal Cancer.International journal of radiation oncology, biology, physics · 2025Article
- Poor Prognostic Effects of Lymphocytopenia Induced by Preoperative Chemoradiotherapy in Rectal Cancer.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Immune System Dose With Proton Versus Photon Radiotherapy for Treatment of Locally Advanced NSCLC.International journal of particle therapy · 2024Article
- Analytical models for external photon beam radiotherapy out-of-field dose calculation: a scoping review.Frontiers in oncology · 2023Article
- The current understanding of the immune landscape relative to radiotherapy across tumor types.Frontiers in immunology · 2023Review
- Review
- Quality-of-life and toxicity in cancer patients treated with multiple courses of radiation therapy.Clinical and translational radiation oncology · 2022Article
- Prediction and clinical impact of delayed lymphopenia after chemoradiotherapy in locally advanced non-small cell lung cancer.Frontiers in oncology · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLymphopenia during radiotherapy (RT) may have an adverse effect on treatment outcome. The aim of this study is to investigate associations between lymphopenia and RT parameters in patients with advanced lung cancer. Moreover, to investigate the prognostic role of lymphopenia, blood protein levels, and treatment and patient-related factors. MATERIAL AND
methodsSixty-two advanced stage non-small cell lung cancer (NSCLC) patients were retrospectively analyzed. Blood counts were available prior to, during, and after RT (3Gyx10). For each patient, a thoracic volume of interest (VOI) -including thoracic soft tissue and trabecular bone- was obtained by applying a CT window of -500 to 1200 HU in the planning CT. Dose parameters from thoracic VOI and other regions including lungs and vertebrae were calculated. Association between risk of lymphopenia ≥ G3 (lymphocytes at nadir according to CTCAE v4.0) and therapeutic parameters was investigated using Logistic regression. Relationships between overall survival (OS) and RT dose parameters, baseline blood counts and protein levels, and clinical factors were evaluated using Log-rank and Cox models.
resultMean thoracic RT dose (odds ratio [OR] 1.67; p = 0.04), baseline lymphocytes (OR 0.65; p = 0.01), and corticosteroids use (OR 6.07; p = 0.02) were significantly associated with increased risk of lymphopenia ≥ G3 in multivariable analysis. Worse OS was associated with high mean thoracic RT dose, high CRP/Albumin, large tumor volume and corticosteroids use (p < 0.05, univariate analysis), but not with lymphopenia ≥ G3. CRP/Albumin ratio > 0.12 (hazard ratio [HR] 2.28, p = 0.03) and corticosteroid use (HR 2.52, p = 0.01) were independently associated with worse OS.
conclusionHigh thoracic RT dose gave a higher risk of lymphopenia ≥ G3; hence limiting dose volume to the thorax may be valuable in preventing severe lymphopenia for patients receiving palliative fractionated RT. Still, lymphopenia ≥ G3 was not associated with worse OS. however, high baseline CRP/Albumin was associated with poorer OS and may carry important information as a prognostic factor of OS in advanced NSCLC receiving palliative RT.
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