Impact of Treatment-Related Lymphopenia on Immunotherapy for Advanced Non-Small Cell Lung Cancer
| Autor: | Byoung Chul Cho, Ju-Young Park, Yeona Cho, Sangjoon Park, Sinae Kim, Hye Ryun Kim, Jaeho Cho, Hwa Kyung Byun, Hong In Yoon, Chang Geol Lee, Min Hee Hong |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Time Factors medicine.medical_treatment Antineoplastic Agents Antibodies Monoclonal Humanized 030218 nuclear medicine & medical imaging 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Carcinoma Non-Small-Cell Lung Lymphopenia Internal medicine Odds Ratio Carcinoma Humans Medicine Radiology Nuclear Medicine and imaging Lymphocyte Count Progression-free survival Lung cancer Aged Retrospective Studies Aged 80 and over Radiation Radiotherapy business.industry Retrospective cohort study Odds ratio Immunotherapy Middle Aged medicine.disease Ipilimumab Progression-Free Survival Radiation therapy Nivolumab 030220 oncology & carcinogenesis Monoclonal Female business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 105:1065-1073 |
| ISSN: | 0360-3016 |
| Popis: | The interest in combining radiation therapy (RT) with immunotherapy is increasing. We investigated the significance of lymphopenia in patients receiving immunotherapy for non-small cell lung cancer (NSCLC), and the factors associated with treatment-related lymphopenia, with particular emphasis on RT.In this retrospective single institution study, 268 patients with advanced NSCLC received immunotherapy, of whom 146 received RT. Lymphopenia was defined as an absolute lymphocyte count1000 cells/mm.At median 6.4 months of follow-up, patients with peri-immunotherapy lymphopenia (n = 146; 54.5%) showed significantly poorer progression-free survival (PFS) (median PFS: 2.2 vs 5.9 months, P.001) and overall survival (OS) (median OS: 5.7 vs 12.1 months, P.001). On multivariate analysis, peri-immunotherapy lymphopenia remained a significant prognostic factor for both PFS and OS. RT significantly increased peri-immunotherapy lymphopenia with an odds ratio (OR) of 1.91 (P = .025). Factors associated with the development of RT-associated lymphopenia included multiple courses (OR, 3.78; P.001), multiple irradiated sites (OR, 4.77; P = .018), and higher dose (≥50 Gy) (OR, 3.75; P = .004). Conversely, stereotactic body RT/radiosurgery reduced the risk (OR 0.21; P = .002).Lymphopenia was indicative of poor prognosis in NSCLC patients receiving immunotherapy and was significantly associated with more intensive RT. Choosing appropriate RT regimens and techniques may be essential in reducing lymphopenia. Promising results are expected in the era of precision RT. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|