Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/226313 |
Resumo: | Background: We evaluated the impact of thoracic radiation in patients withnon-small cell lung cancer (NSCLC), considering the depletion of total lympho-cytes, use or not of chemotherapy, and radiation doses in healthy lung tissue.Methods: Patients with stage III NSCLC, ECOG 0 to 2, receiving radiothera pywith or without chemotherapy were prospectively evaluated. All patients shouldbe treated with three-dimensional radiotherapy and received biologically effectivedoses (BED10α/β 10) of 48 to 80 Gy. Peripheral blood lymphocyte total countswere measured at the start of radiotherapy and at 2, 6 and 12 months after radio-therapy. Along with lymphocytes, PTV and doses of 5 Gy and 20 Gy in healthylung tissue were also evaluated as potential factors inuencing overall survival(OS) and progression-free survival (PFS).Results: A total of 46 patients were prospectively evaluated from April 2016 toAugust 2019, with a median follow-up of 13 months (interquartile range, 1–39months). The median of OS of all cohort was 22,8 months (IC 95% 17,6–28,1)and the median PFS was 19,5 months (IC 95%: 14,7–24,2). Most patientsreceived concurrent or neoadjuvant chemotherapy (43; 93.4%). No patientreceived adjuvant immunotherapy. The lower the lymphocyte loss at 6 monthsafter radiotherapy (every 100 lymphocytes/mcL), the greater the chance of PFS(HR, 0.44; 95%CI, 0.25–0.77; P = 0.004) and OS (HR, 0.83; 95%CI, 0.70–0.98;P = 0.025; P = 0.025). BED was a protective factor for both PFS (HR, 0.52; 95%CI 0.33 –0.83; P = 0.0006) and OS (HR, 0.73; 95%CI 0.54–0.97; P = 0.029).Conclusions: Our results suggest that lymphocyte depletion after radiotherapyreduces tumor control and survival in patients with stage III lung cancer. Radia-tion doses equal or higher than 60 Gy (BED1072 Gy) improve PFS and OS, butthey negatively affect lymphocyte counts for months, which reduces survival andthe potential of immunotherapy. |
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Matiello, JulianaDal Prá, Alan L.Zardo, LaiseSilva, RicardoBerton, Danilo Cortozi2021-08-31T04:20:48Z20201759-7706http://hdl.handle.net/10183/226313001129830Background: We evaluated the impact of thoracic radiation in patients withnon-small cell lung cancer (NSCLC), considering the depletion of total lympho-cytes, use or not of chemotherapy, and radiation doses in healthy lung tissue.Methods: Patients with stage III NSCLC, ECOG 0 to 2, receiving radiothera pywith or without chemotherapy were prospectively evaluated. All patients shouldbe treated with three-dimensional radiotherapy and received biologically effectivedoses (BED10α/β 10) of 48 to 80 Gy. Peripheral blood lymphocyte total countswere measured at the start of radiotherapy and at 2, 6 and 12 months after radio-therapy. Along with lymphocytes, PTV and doses of 5 Gy and 20 Gy in healthylung tissue were also evaluated as potential factors inuencing overall survival(OS) and progression-free survival (PFS).Results: A total of 46 patients were prospectively evaluated from April 2016 toAugust 2019, with a median follow-up of 13 months (interquartile range, 1–39months). The median of OS of all cohort was 22,8 months (IC 95% 17,6–28,1)and the median PFS was 19,5 months (IC 95%: 14,7–24,2). Most patientsreceived concurrent or neoadjuvant chemotherapy (43; 93.4%). No patientreceived adjuvant immunotherapy. The lower the lymphocyte loss at 6 monthsafter radiotherapy (every 100 lymphocytes/mcL), the greater the chance of PFS(HR, 0.44; 95%CI, 0.25–0.77; P = 0.004) and OS (HR, 0.83; 95%CI, 0.70–0.98;P = 0.025; P = 0.025). BED was a protective factor for both PFS (HR, 0.52; 95%CI 0.33 –0.83; P = 0.0006) and OS (HR, 0.73; 95%CI 0.54–0.97; P = 0.029).Conclusions: Our results suggest that lymphocyte depletion after radiotherapyreduces tumor control and survival in patients with stage III lung cancer. Radia-tion doses equal or higher than 60 Gy (BED1072 Gy) improve PFS and OS, butthey negatively affect lymphocyte counts for months, which reduces survival andthe potential of immunotherapy.application/pdfengThoracic cancer. Singapore. Vol. 11 (2020), p. 3139–3144.Contagem de linfócitosNeoplasias pulmonaresIntervalo livre de progressãoSobrevidaRadioterapiaLymphocyte countNon-small cell lung cancerProgression-free survivalSurvivalThoracic irradiationImpacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancerEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001129830.pdf.txt001129830.pdf.txtExtracted Texttext/plain24752http://www.lume.ufrgs.br/bitstream/10183/226313/2/001129830.pdf.txtf0adf5d39b8f5cfc35fcbe73ba42c63aMD52ORIGINAL001129830.pdfTexto completo (inglês)application/pdf218904http://www.lume.ufrgs.br/bitstream/10183/226313/1/001129830.pdfa3659d5340a0a5268a980e4dbe4791d2MD5110183/2263132021-09-19 04:30:51.921098oai:www.lume.ufrgs.br:10183/226313Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2021-09-19T07:30:51Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
title |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
spellingShingle |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer Matiello, Juliana Contagem de linfócitos Neoplasias pulmonares Intervalo livre de progressão Sobrevida Radioterapia Lymphocyte count Non-small cell lung cancer Progression-free survival Survival Thoracic irradiation |
title_short |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
title_full |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
title_fullStr |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
title_full_unstemmed |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
title_sort |
Impacts of post-radiotherapy lymphocyte count onprogression-free and overall survival in patients with stage III lung cancer |
author |
Matiello, Juliana |
author_facet |
Matiello, Juliana Dal Prá, Alan L. Zardo, Laise Silva, Ricardo Berton, Danilo Cortozi |
author_role |
author |
author2 |
Dal Prá, Alan L. Zardo, Laise Silva, Ricardo Berton, Danilo Cortozi |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Matiello, Juliana Dal Prá, Alan L. Zardo, Laise Silva, Ricardo Berton, Danilo Cortozi |
dc.subject.por.fl_str_mv |
Contagem de linfócitos Neoplasias pulmonares Intervalo livre de progressão Sobrevida Radioterapia |
topic |
Contagem de linfócitos Neoplasias pulmonares Intervalo livre de progressão Sobrevida Radioterapia Lymphocyte count Non-small cell lung cancer Progression-free survival Survival Thoracic irradiation |
dc.subject.eng.fl_str_mv |
Lymphocyte count Non-small cell lung cancer Progression-free survival Survival Thoracic irradiation |
description |
Background: We evaluated the impact of thoracic radiation in patients withnon-small cell lung cancer (NSCLC), considering the depletion of total lympho-cytes, use or not of chemotherapy, and radiation doses in healthy lung tissue.Methods: Patients with stage III NSCLC, ECOG 0 to 2, receiving radiothera pywith or without chemotherapy were prospectively evaluated. All patients shouldbe treated with three-dimensional radiotherapy and received biologically effectivedoses (BED10α/β 10) of 48 to 80 Gy. Peripheral blood lymphocyte total countswere measured at the start of radiotherapy and at 2, 6 and 12 months after radio-therapy. Along with lymphocytes, PTV and doses of 5 Gy and 20 Gy in healthylung tissue were also evaluated as potential factors inuencing overall survival(OS) and progression-free survival (PFS).Results: A total of 46 patients were prospectively evaluated from April 2016 toAugust 2019, with a median follow-up of 13 months (interquartile range, 1–39months). The median of OS of all cohort was 22,8 months (IC 95% 17,6–28,1)and the median PFS was 19,5 months (IC 95%: 14,7–24,2). Most patientsreceived concurrent or neoadjuvant chemotherapy (43; 93.4%). No patientreceived adjuvant immunotherapy. The lower the lymphocyte loss at 6 monthsafter radiotherapy (every 100 lymphocytes/mcL), the greater the chance of PFS(HR, 0.44; 95%CI, 0.25–0.77; P = 0.004) and OS (HR, 0.83; 95%CI, 0.70–0.98;P = 0.025; P = 0.025). BED was a protective factor for both PFS (HR, 0.52; 95%CI 0.33 –0.83; P = 0.0006) and OS (HR, 0.73; 95%CI 0.54–0.97; P = 0.029).Conclusions: Our results suggest that lymphocyte depletion after radiotherapyreduces tumor control and survival in patients with stage III lung cancer. Radia-tion doses equal or higher than 60 Gy (BED1072 Gy) improve PFS and OS, butthey negatively affect lymphocyte counts for months, which reduces survival andthe potential of immunotherapy. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2021-08-31T04:20:48Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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info:eu-repo/semantics/publishedVersion |
format |
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publishedVersion |
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http://hdl.handle.net/10183/226313 |
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1759-7706 |
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001129830 |
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http://hdl.handle.net/10183/226313 |
dc.language.iso.fl_str_mv |
eng |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Thoracic cancer. Singapore. Vol. 11 (2020), p. 3139–3144. |
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