Significance of lymphocyte recovery from treatment-related lymphopenia in locally advanced pancreatic cancer
Significance of lymphocyte recovery from treatment-related lymphopenia in locally advanced pancreatic cancer
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DOI：
10.1016/j.radonc.2020.07.026
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发表时间：
2020-10-01
影响因子：
5.7
通讯作者：
Seong, Jinsil
中科院分区：
文献类型：
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作者：
Lee, Byung Min;Byun, Hwa Kyung;Seong, Jinsil
背景和目的：放射诱导的淋巴细胞减少症与胰腺癌切除术和局部晚期胰腺癌的预后不良相关。然而，淋巴细胞恢复是否有助于胰腺癌预后还没有得到很好的investigated.Materials和方法：我们评估了497例局部晚期胰腺癌患者进行同步放化疗（CCRT）。在CCRT之前、期间和之后直至12个月随访访视，获得患者的全血细胞计数。根据急性重度淋巴细胞减少症（ASL）的发生和恢复情况将患者分为3组：无ASL（A组，n = 198）、ASL恢复（B组，n = 141）和ASL未恢复（C组，n = 89）。结果：A、B、C组2年总生存率分别为40.4%、31.9%、14.6%，2年无进展生存率分别为23.7%、18.4%、10.1%。A组和B组的OS和PFS相当，而C组的OS和PFS较差（p < 0.001）。ASL恢复上级（HR 0.42，95% CI：0.32-0.55，p < 0.001）和PFS（HR 0.53，95% CI：0.41-0.70，p < 0.001）更优相关。基线淋巴细胞计数和目标体积独立预测的发展和恢复ASL.Conclusion：ASL的恢复与谁接受CCRT局部晚期胰腺癌患者上级OS和PFS均优于。基线淋巴细胞计数和靶体积与治疗相关ASL的发生和恢复相关。(C)2020爱思唯尔B. V.保留所有权利。
Background and purpose: Radiation-induced lymphopenia is associated with poor prognosis in resected pancreatic cancer and locally advanced pancreatic cancer. However, whether lymphocyte recovery contributes to pancreatic cancer prognosis has not been well-investigated.Materials and methods: We evaluated 497 locally advanced pancreatic cancer patients who underwent concurrent chemoradiotherapy (CCRT). Complete blood counts of patients were obtained before, during, and after CCRT until the 12-month follow-up visit. Patients were categorized into 3 groups according to the development of and recovery from acutte severe lymphopenia (ASL): no ASL (group A, n = 198), recovery from ASL (group B, n = 141), and no recovery from ASL (group C, n = 89). Prognostic factors of overall survival (OS) and progression-free survival (PFS) were determined using Cox regression analyses.Results: In groups A, B, and C, the 2-year OS rates were 40.4%, 31.9%, and 14.6%, respectively, and the 2year PFS rates were 23.7%, 18.4%, and 10.1%, respectively. OS and PFS were comparable between Groups A and B, while group C had poor OS and PFS (p < 0.001). Recovery from ASL was associated with superior OS (HR 0.42, 95% CI: 0.32-0.55, p < 0.001) and PFS (HR 0.53, 95% CI: 0.41-0.70, p < 0.001). The baseline lymphocyte counts and target volume independently predicted development and recovery from ASL.Conclusion: Recovery from ASL was associated with both superior OS and PFS in patients who received CCRT for locally advanced pancreatic cancer. Baseline lymphocyte counts and target volume were associated with both the development of and recovery from treatment-related ASL. (C) 2020 Elsevier B.V. All rights reserved.