ArticleNeuro-oncology advances
Impact of lymphopenia on survival for elderly patients with glioblastoma: A secondary analysis of the CCTG CE.6 (EORTC 26062-22061, TROG03.01) randomized clinical trial.
Article in Neuro-oncology advances. 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 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Prognostic and clinicopathological effect of the prognostic nutritional index (PNI) in patients with cervical cancer: a meta-analysis.Annals of medicine · 2023Pooled it
- Clinical, molecular, and immunologic determinants of survival in WHO-defined IDH-wildtype glioblastoma treated with radiotherapy: a large real-world cohort study.Journal of neuro-oncology · 2026Article
- Radiotherapy and survival in elderly grade 4 glioma patients: The prognostic value of onco-functional outcome.Clinical and translational radiation oncology · 2026Article
- Dynamic blood dose estimates in radiotherapy and correlations with adverse clinical outcomes in brain, head-and-neck, and lung cancer patients.Journal of applied clinical medical physics · 2026Article
- Assessment of prognostic value and development of predictive model for prolonged lymphopenia in patients with glioblastoma following chemoradiotherapy.Journal of radiation research · 2025Article
- Correlation of dynamic blood dose with clinical outcomes in radiotherapy for head-and-neck cancer.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025Article
- Systemic Candida abscess after hypofractionated radiotherapy with temozolomide for glioblastoma in an older patient: illustrative case.Journal of neurosurgery. Case lessons · 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
- Systemic and local immunosuppression in glioblastoma and its prognostic significance.Frontiers in immunology · 2024Review
- Perioperative dexamethasone in high-grade gliomas: the short-term benefits and long-term harms.Frontiers in oncology · 2023Article
- A Conceptual Framework for Inducing T Cell-Mediated Immunity Against Glioblastoma.Seminars in immunopathology · 2022Review
- Optimal managements of elderly patients with glioblastoma.Japanese journal of clinical oncology · 2022Review
- Preoperative Prognostic Nutritional Index Predict Survival in Patients With Resectable Esophageal Squamous Cell Carcinoma.Frontiers in nutrition · 2022Article
- Radiotherapy for Newly Diagnosed Glioblastoma in the Elderly: What Is the Standard?Brain tumor research and treatment · 2022Review
- Impact of intensity-modulated proton therapy in reducing radiation-induced lymphopenia in glioma patients.Neuro-oncology advancesArticle
Corrections and comments
- Erratum issued
Authors and funding
18 authors at 10 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLymphopenia may lead to worse outcomes for glioblastoma patients. This study is a secondary analysis of the CCTG CE.6 trial evaluating the impact of chemotherapy and radiation on lymphopenia, and effects of lymphopenia on overall survival (OS).
methodsCCTG CE.6 randomized elderly glioblastoma patients (≥ 65 years) to short-course radiation alone (RT) or short-course radiation with temozolomide (RT + TMZ). Lymphopenia (mild-moderate: grade 1-2; severe: grade 3-4) was defined per CTCAE v3.0, and measured at baseline, 1 week and 4 weeks post-RT. Preselected key factors for analysis included age, sex, ECOG, resection extent, MGMT methylation, Mini-Mental State Examination, and steroid use. Multinomial logistic regression and multivariable Cox regression models were used to identify lymphopenia-associated factors and association with survival.
resultsFive hundred and sixty-two patients were analyzed (281 RT vs 281 RT+TMZ). At baseline, both arms had similar rates of mild-moderate (21.4% vs 21.4%) and severe (3.2% vs 2.9%) lymphopenia. However, at 4 weeks post-RT, RT+TMZ was more likely to develop lymphopenia (mild-moderate: 27.9% vs 18.2%; severe: 9.3% vs 1.8%; p<0.001). Developing any lymphopenia post-RT was associated with baseline lymphopenia (
conclusionsDevelopment of post-RT lymphopenia is associated with addition of TMZ and baseline lymphopenia and not with RT alone in patients treated with short-course radiation. However, regardless of MGMT status, only baseline lymphopenia is associated with worse OS, which may be considered as a prognostic biomarker for elderly glioblastoma patients.
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