ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2022
Lymphocyte dynamics during and after chemo-radiation correlate to dose and outcome in stage III NSCLC patients undergoing maintenance immunotherapy.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Synergies between radiotherapy and immunotherapy: a systematic review from mechanism to clinical application.Frontiers in immunology · 2025Pooled it
- Influence of treatment-related lymphopenia on the efficacy of immune checkpoint inhibitors in lung cancer: a meta-analysis.Frontiers in oncology · 2023Pooled it
- Therapeutic vaccines for NSCLC: From mechanisms to clinical translation.Chinese medical journal pulmonary and critical care medicine · 2026Review
- Immune-sparing radiotherapy in solid tumors: radiation-induced lymphopenia, circulating immune-cell dose, and biomarker-guided optimization of radioimmunotherapy.Journal of cancer research and clinical oncology · 2026Review
- Review
- A Failure Pattern Analyses in NSCLC Patients Received Immuno-Radiotherapy and a Dosimetric Feasibility Study of a Three-Ladder Radiotherapy Strategy.Cancer management and research · 2026Article
- Long-term efficacy of traditional Chinese medicine combined with chemotherapy for advanced non-small cell lung cancer: a systematic review and meta-analysis of reconstructed individual patient data over 3 years.Frontiers in pharmacology · 2026Review
- Radiation-induced lymphopenia: A data compilation to unveil relevant factors and mitigation strategies.Clinical and translational radiation oncology · 2026Review
- Prediction of differentiation levels in lung adenocarcinoma using peripheral blood inflammatory cytokines and tumor markers.PloS one · 2026Article
- Clinical Considerations of Splenic Dose Constraints to Mitigate Radiation-Induced Lymphopenia.Cancer medicine · 2026Article
- Article
- Longitudinal Analyses and Predictive Factors of Radiation-Induced Lymphopenia After Postmastectomy Hypofractionated Radiation Therapy for Breast Cancer: A Pooled Cohort Study of 2 Prospective Trials.Advances in radiation oncology · 2025Article
- In Silico-Designed TGFβRI/TGFβRII Receptor Complex Peptide Inhibitors Exhibit Biological Activity In Vitro.Journal of cellular and molecular medicine · 2025Article
- Unraveling the Impact of Sarcopenia-Induced Lymphopenia on Treatment Response and Prognosis in Patients with Stage III Non-Small Cell Lung Cancer: Insights for Optimizing Chemoradiation and Immune Checkpoint Inhibitor.Cancer research and treatment · 2025Article
- Early recovery of leukocyte subsets is associated with favorable progression-free survival in patients with inoperable stage II/III NSCLC after multimodal treatment: a prospective explorative study.Radiation oncology (London, England) · 2025Article
- Mathematical Modeling Predicts Optimal Immune Checkpoint Inhibitor and Radiotherapy Combinations and Timing of Administration.Cancer immunology research · 2025Article
- The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis.Radiation oncology (London, England) · 2025Article
- Normal tissue complication probability model for severe radiation-induced lymphopenia in patients with pancreatic cancer treated with concurrent chemoradiotherapy.Physics and imaging in radiation oncology · 2025Article
- Prognostic value of neutrophil to lymphocyte ratio and lymphocyte counts before durvalumab consolidation after radio-chemotherapy in locally advanced non-small cell lung cancer.Radiation oncology (London, England) · 2024Article
- Understanding the impact of radiation-induced lymphopenia: Preclinical and clinical research perspectives.Clinical and translational radiation oncology · 2024Review
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeWe investigated the dynamics of lymphocyte depletion and recovery during and after definitive concurrent chemoradiotherapy (CCRT), dose to which structures is correlated to them, and how they affect the prognosis of stage III non-small cell lung cancer (NSCLC) patients undergoing maintenance immunotherapy. METHODS AND MATERIALS: In this retrospective study, absolute lymphocyte counts (ALC) of 66 patients were obtained before, during, and after CCRT. Persistent lymphopenia was defined as ALC < 500/μL at 3 months after CCRT. The impact of regional dose on lymphocyte depletion and recovery was investigated using voxel-based analysis (VBA).
resultsMost patients (n = 65) experienced lymphopenia during CCRT: 39 patients (59.0%) had grade (G) 3+ lymphopenia. Fifty-nine patients (89.3%) recovered from treatment-related lymphopenia at 3 months after CCRT, whereas 7 (10.6%) showed persistent lymphopenia. Patient characteristics associated with persistent lymphopenia were older age and ALC before and during treatment. In multivariable Cox regression analysis, recovery from lymphopenia was identified as a significant prognostic factor for Progression Free Survival (HR 0.35, 95% CI 0.13-0.93, p = 0.034) and Overall Survival (HR 0.24, 95% CI 0.08-0.68, p = 0.007). Voxel-based analysis showed strong correlation of dose to the upper mediastinum with lymphopenia at the end of CCRT, but not at 3 months after CCRT.
conclusionRecovery from lymphopenia is strongly correlated to improved survival of patients undergoing CCRT and adjuvant immunotherapy, and is correlated to lymphocyte counts pre- and post-CCRT. VBA reveals high correlation of dose to large vessels to lymphopenia at the end of CCRT. Therefore, efforts should be made not only for preventing lymphocyte depletion during CCRT but also for helping lymphocyte recovery after CCRT.
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