ArticleJournal of radiation research2024
The relationship between splenic dose and radiation-induced lymphopenia.
Article in Journal of radiation research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Clinical Considerations of Splenic Dose Constraints to Mitigate Radiation-Induced Lymphopenia.Cancer medicine · 2026Article
- Combining advanced radiotherapy techniques and immunotherapy: immunomodulatory mechanisms and clinical prospects.Frontiers in immunology · 2026Review
- Changes in splenic volumes following stereotactic ablative radiotherapy (SABR) to adrenal tumors.Clinical and translational radiation oncology · 2025Article
- Preclinical Comparison of [Molecular pharmaceutics · 2025Article
- Radiation-Induced Lymphopenia Prognosis and Risk Factors in Postmastectomy Radiotherapy Patients.Cancer management and research · 2025Article
- Thymosin α1 Elevates Lymphocyte Counts and Improves Immunoradiotherapy Outcomes in Patients with Advanced Cancer.Cancer management and research · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Lymphocytes, which are highly sensitive to radiation, play a crucial role in the body's defense against tumors. Radiation-induced lymphopenia has been associated with poorer outcomes in different cancer types. Despite being the largest secondary lymphoid organ, the spleen has not been officially designated as an organ at risk. This study hypothesizes a connection between spleen irradiation and lymphopenia and seeks to establish evidence-based dosage limits for the spleen. We retrospectively analyzed data from 96 patients with locally advanced gastric cancer who received postoperative chemoradiotherapy (CRT) between May 2010 and May 2017. Complete blood counts were collected before, during and after CRT. We established a model for predicting the minimum absolute lymphocyte count (Min ALC) and to investigate potential associations between spleen dosimetric variables and Min ALC. The median follow-up was 60 months. The 5-year overall survival (OS) and disease-free survival (DFS) were 65.2% and 56.8%, respectively. The median values of pre-treatment ALC, Min ALC and post-treatment ALC were 1.40 × 109, 0.23 × 109 and 0.28 × 109/L, respectively. Regression analysis confirmed that the primary tumor location, number of fractions and spleen V5 were significant predictors of Min ALC during radiation therapy. Changes in ALC (ΔALC) were identified as an independent predictor of both OS and DFS. Spleen V5 is an independent predictor for Min ALC, and the maximum dose of the spleen is associated with an increased risk of severe lymphopenia. Therefore, these doses should be restricted in clinical practice. Additionally, ΔALC can serve as a prognostic indicator for adjuvant radiotherapy in gastric cancer.
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Registered trials
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