The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis.

IF 3.3 2区 医学 Q2 ONCOLOGY Radiation Oncology Pub Date : 2025-01-23 DOI:10.1186/s13014-025-02587-x
Hongshan Ji, Ping Zhang, Chanjun Zhen, Liyuan Fu, Dongjie Lv, Wenwen Bai, Rui Zhang, Jing Li, Hang Gao, Yajing Wang, Qiuying An, Yuhao Su, Hanyu Si, Xueying Qiao, Zhiguo Zhou
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Abstract

Background: The impact of radiation-related lymphocyte recovery on prognosis in locally advanced esophageal squamous cell carcinoma (LA-ESCC) remains unclear.

Methods: Patients with stage II-IVa ESCC who received definitive RT were screened. Collect absolute lymphocyte counts (ALCs) before, during, and after RT. The recovery status of lymphocytes was observed at one-month post-RT (P1) and three months post-RT (P3). Patients with relatively lower lymphocyte recovery levels at P1 were divided into Group a and those with higher levels were divided into Group b. Patients with relatively lower lymphocyte recovery levels at P3 were divided into Group A and those higher were divided into Group B. Kaplan-Merier's analysis and Cox analysis were conducted to compare survival outcomes. Binary logistic regression analyses was employed to ascertain factors associated with lymphocyte recovery.

Results: 116 patients were enrolled. During RT, ALCs reached the bottom 5 weeks after RT started and 70.7% of patients experienced G3 lymphopenia. The median OS for Group a and Group b were 38.1 months and 14.4 months, p = 0.097. The median PFS for Group a and Group b were 14.2 months and 10.0 months, p = 0.037. Whereas, the median OS for Group A and Group B was 14.5 months and 22.2 months, p = 0.019. The median PFS for Group A and Group B were 8.4 months and 12.4 months, p = 0.021. Cox multivariable analysis revealed that higher lymphocyte recovery level at P3 was significantly associated with superior OS (p = 0.040, HR0.636) and PFS (p = 0.028, HR0.627). The logistic analysis identified a positive association between G4 lymphopenia during RT (p = 0.012, OR 7.742) and PTV dose < 60 Gy (p = 0.014, OR 2.655) with lymphocyte recovery.

Conclusions: The prognostic value of lymphocyte recovery status at P3 appears to be greater than that of lymphocyte recovery status at P1 for locally advanced ESCC patients. Radiation-related lymphocyte recovery might serve as a valuable prognostic factor in LA-ESCC.

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放射相关淋巴细胞恢复对局部晚期食管鳞状细胞癌患者预后影响的回顾性分析。
背景:放射相关淋巴细胞恢复对局部晚期食管鳞状细胞癌(LA-ESCC)预后的影响尚不清楚。方法:对接受最终放疗的II-IVa期ESCC患者进行筛查。分别在治疗前、治疗中、治疗后收集淋巴细胞绝对计数(ALCs)。分别于治疗后1个月(P1)和3个月(P3)观察淋巴细胞恢复情况。P1时淋巴细胞恢复水平较低的患者分为a组,较高的患者分为b组。P3时淋巴细胞恢复水平较低的患者分为a组,较高的患者分为b组。采用Kaplan-Merier分析和Cox分析比较生存结局。采用二元logistic回归分析确定与淋巴细胞恢复相关的因素。结果:116例患者入组。在放疗期间,ALCs在放疗开始后5周降至最低,70.7%的患者出现G3淋巴细胞减少。a组和b组的中位OS分别为38.1个月和14.4个月,p = 0.097。a组和b组的中位PFS分别为14.2个月和10.0个月,p = 0.037。而A组和B组的中位OS分别为14.5个月和22.2个月,p = 0.019。A组和B组的中位PFS分别为8.4个月和12.4个月,p = 0.021。Cox多变量分析显示,P3期淋巴细胞恢复水平越高,OS越好(p = 0.040, HR0.636), PFS越好(p = 0.028, HR0.627)。logistic分析发现,放疗期间G4淋巴细胞减少与PTV剂量呈正相关(p = 0.012, OR 7.742)。结论:对于局部晚期ESCC患者,P3期淋巴细胞恢复状态的预后价值似乎大于P1期淋巴细胞恢复状态。放射相关淋巴细胞恢复可能是LA-ESCC的一个有价值的预后因素。
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来源期刊
Radiation Oncology
Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
6.50
自引率
2.80%
发文量
181
审稿时长
3-6 weeks
期刊介绍: Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.
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