ArticleFrontiers in oncology2025
Temporal dynamics of lymphocytes in prostate cancer patients treated with proton therapy.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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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
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Enhanced efficacy of lung cancer treatment with radiotherapy and immune checkpoint inhibitors without increased pneumonia risk: a systematic review and meta-analysis of randomized controlled trials.Frontiers in immunology · 2025Pooled it
- Predictive Factors for Acute and Late Genitourinary and Gastrointestinal Toxicity Following Modern Radiotherapy for Prostate Cancer: A Narrative Review of Clinical, Dosimetric, Immunological, and Genetic Determinants.Life (Basel, Switzerland) · 2026Review
- Carbon ion irradiation at a clinically used dose rewires super-enhancers to drive necroptosis and systemic immunity.Science advances · 2026Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Radiotherapy can be both immunosuppressive and immunostimulatory. Radiation-induced lymphopenia (RIL) is an ongoing challenge in cancer treatment. We investigated weekly changes in the absolute lymphocyte count (ALC) during proton radiotherapy, evaluating the effects of different dosage, fractionation schedules, and pelvic node irradiation (PNI). Prostate cancer patients were prospectively chosen for this study, due to their relatively homogenous treatment plans. Treatment protocols were categorized into three groups: Group A (n=52) received 36.25 Gy/5-fractions, Group B (n=60) underwent 63 Gy/21-fractions and group C (n=69) received 63 Gy/21-fractions plus PNI. To account for individual characteristic differences, a new categorization method was made, according to the change in ALC relative to the baseline. Lymphopenia (ALC < 1000 K/μL) developed in 8%, 17% and 84% of patients in groups A, B, and C, respectively. An initial increase in ALC occurred in 44%, 47% and 28% of groups A, B and C, respectively, and declined with proceeding fractions. Patients with PNI had the most pronounced reduction in their ALC relative to the baseline. Increased dosage and fractionation led to a higher incidence of lymphopenia. Understanding which factors influence ALC in particle therapy is vital for leveraging the immune-enhancing effects of radiotherapy, while minimising its immunosuppressive impacts.
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