ArticlePhysics and imaging in radiation oncology2024
Dose-volume metric-based prediction of radiotherapy-induced lymphocyte loss in patients with non-small-cell lung cancer treated with modern radiotherapy techniques.
Article in Physics and imaging in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- 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
- Assessment of proton versus photon therapy in the reduction of lymphopaenia in thoracic cancers: A scoping review.Technical innovations & patient support in radiation oncology · 2026Review
- Nutritional risk and cancer pain as determinants of radiotherapy-induced severe lymphocytopenia: development and validation of a nutrition-integrated predictive nomogram.Frontiers in nutrition · 2026Article
- The Evolving Role of Local Radiotherapy in the Management of Oligometastatic Non-Small Cell Lung Cancer.Cancer management and research · 2026Review
- Radiation-induced lymphopenia: A data compilation to unveil relevant factors and mitigation strategies.Clinical and translational radiation oncology · 2026Review
- 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
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15 authors.
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Abstract
Background and Purpose: Radiation-induced lymphopenia (RIL) is a common side effect of radiotherapy (RT) that may negatively impact survival. We aimed to identify RIL predictors in patients with non-small-cell lung cancer (NSCLC) treated intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). Materials and Methods: We retrospectively analysed data of 306 patients who underwent radical RT for NSCLC. Absolute lymphocyte count (ALC) loss was evaluated for each patient by fitting an exponential decay curve to data from first 45 days since treatment start, and percentage ALC loss relative to baseline was calculated based on area under the decay curve and baseline ALC. We compared IMRT and VMAT treatment plans and used linear regression to predict ALC loss. Results: ALC decreased during RT in the whole patient group, while neutrophil counts remained stable and decreased only in those treated with concurrent chemoradiotherapy (CRT). Percentage ALC loss ranged between 11 and 78 % and was more strongly than lymphocyte nadir correlated with dose-volume metrics for relevant normal structures. We found evidence for the association of high radiation dose to the lungs, heart and body with percentage ALC loss, with lung volume exposed to 20-30 Gy being most important predictors in patients treated with IMRT. A multivariable model based on CRT use, baseline ALC and first principal component (PC1) of the dose-volume predictors showed good predictive performance (bias-corrected R Conclusion: Percentage lymphocyte loss is a robust measure of RIL that is predicted by baseline ALC, CRT use and dose-volume parameters to the lungs, heart and body.
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