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Significance of lymphocyte recovery from treatment-related lymphopenia in locally advanced pancreatic cancer

Authors
 Byung Min Lee  ;  Hwa Kyung Byun  ;  Jinsil Seong 
Citation
 RADIOTHERAPY AND ONCOLOGY, Vol.151 : 82-87, 2020-10 
Journal Title
 RADIOTHERAPY AND ONCOLOGY 
ISSN
 0167-8140 
Issue Date
2020-10
Keywords
Lymphocyte count ; Pancreatic neoplasms ; Prognosis ; Radiation-induced lymphopenia
Abstract
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 2-year 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.
Full Text
https://www.sciencedirect.com/science/article/pii/S0167814020304205
DOI
10.1016/j.radonc.2020.07.026
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Byun, Hwa Kyung(변화경) ORCID logo https://orcid.org/0000-0002-8964-6275
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Byung Min(이병민)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180161
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