ArticleFrontiers in oncology2023
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.
Article in Frontiers in oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Impact of Proton versus Photon (Chemo)radiation on Circulating Immune Cells in Head and Neck Cancer.Cancer research communications · 2026Article
- The microbiota-lymphocyte protective axis (MLPA): a novel paradigm for overcoming radiation-induced lymphopenia (RIL) and potentiating the efficacy of tumor immuno-combination therapy.Cancer immunology, immunotherapy : CII · 2026Review
- Preliminary treatment planning strategy for blood dose reduction in head and neck radiotherapy.Journal of applied clinical medical physics · 2026Article
- Blood dose estimates in radiotherapy and correlations with adverse clinical outcomes in hepatocellular carcinoma.Journal of radiation research · 2026Article
- Patient-specific modeling of radiation-induced lymphopenia for head and neck cancer.Medical physics · 2025Article
- Prediction of Grade 4 radiation-induced lymphopenia during chemoradiation therapy for lung cancer patients: Insights from two past trials.Physics and imaging in radiation oncology · 2025Article
- Effects of ionizing radiations of different qualities and delivery types on blood cells.Biophysical reviews · 2025Review
- Toward real-time, volumetric dosimetry for FLASH-capable clinical synchrocyclotrons using protoacoustic imaging.Medical physics · 2024Article
- Proton radiation boosts the efficacy of mesothelin-targeting chimeric antigen receptor T cell therapy in pancreatic cancer.Proceedings of the National Academy of Sciences of the United States of America · 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
- Clinical application of high-LET radiotherapy combined with immunotherapy in malignant tumors.Precision radiation oncology · 2024Review
- Early lymphocyte levels and low doses radiation exposure of lung predict lymphopenia in radiotherapy for lung cancer.Frontiers in immunology · 2024Observational
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: We estimated the dose of circulating blood cells (CBCs) in patients with locally advanced non-small cell lung cancer for predicting severe radiation-induced lymphopenia (SRIL) and compared pencil-beam scanning proton therapy (PBSPT) and intensity-modulated (photon) radiotherapy (IMRT). Materials and methods: After reviewing 325 patients who received definitive chemoradiotherapy with PBSPT (n = 37) or IMRT (n = 164). SRIL was diagnosed when two or more events of an absolute lymphocyte count < 200 µL occurred during the treatment course. Dose information for the heart and lungs was utilized for the time-dependent computational dose calculation of CBCs. Results: The dose distribution of CBCs was significantly lesser in the PBSPT group than that in the IMRT group. Overall, 75 (37.3%) patients experienced SRIL during the treatment course; 72 and 3 patients were treated with IMRT and PBSPT, respectively. SRIL was associated with poor progression-free and overall survival outcomes. Upon incorporating the dose information of CBCs for predicting SRIL, CBC D90% > 2.6 GyE was associated with the development of SRIL with the baseline lymphocyte count and target volume. Furthermore, PBSPT significantly reduced the dose of CBC D90% (odds ratio = 0.11; p = 0.004) compared with IMRT. Conclusion: The results of this study demonstrate the significance of the dose distribution of CBCs in predicting SRIL. Furthermore, reducing the dose of CBCs after PBSPT minimized the risk of SRIL. Lymphocyte-sparing radiotherapy in PBSPT could improve outcomes, particularly in the setting of maintenance immunotherapy.
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