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RT-induced dynamic changes in the lymphocyte-to-monocyte ratio in patients with breast cancer indicate poor prognosis

Authors
 Dooreh Kim  ;  Soong June Bae  ;  Sung Gwe Ahn  ;  Joon Jeong  ;  Seho Park  ;  Woo-Chan Park  ;  Goeun Park  ;  Sujee Lee  ;  Chang Ik Yoon 
Citation
 BREAST CANCER RESEARCH AND TREATMENT, Vol.193(3) : 637-647, 2022-06 
Journal Title
BREAST CANCER RESEARCH AND TREATMENT
ISSN
 0167-6806 
Issue Date
2022-06
MeSH
Breast Neoplasms* / pathology ; Breast Neoplasms* / therapy ; Female ; Humans ; Leukocytes, Mononuclear ; Lymphocytes / pathology ; Monocytes* ; Prognosis ; Retrospective Studies
Keywords
Breast cancer ; radiation therapy ; lymphocyte-to-monocyte ratio ; LMR ; Lymphocyte ; Monocyte
Abstract
Purpose: Radiation-induced anti-tumor responses occur in the immune system, particularly in peripheral blood mononuclear cells (PBMCs), which are overly sensitive to ionizing radiation. Irradiation of PBMCs is associated with inflammation. We assessed the association between radiotherapy (RT)-induced changes in peripheral blood cells, utilizing the lymphocyte-to-monocyte ratio (LMR), and survival outcome in breast cancer patients who underwent breast-conserving surgery followed by adjuvant RT.

Methods: LMR values were obtained from retrospective data, and serial sampling of blood before the first and last RT sessions was performed. The cut-off point was analyzed using the Youden index and receiver operating characteristic curve. Recurrence-free survival (RFS) and overall survival (OS) were the main outcomes.

Results: Patients with RT-induced low LMR had significantly shorter RFS (hazard ratio [HR] 2.730; 95% confidence interval [CI], 1.607-4.636, P = 0.0002) and OS (HR 2.890; 95% CI 1.410-5.924, P = 0.0038). The results were more robust in the subgroup of patients who received chemotherapy. Multivariate analysis showed that lymph node metastasis and RT-induced low LMR were associated with poor RFS (HR 1.763; 95% CI, 1.017-3.059, P = 0.044) and OS (HR 2.254; 95% CI, 1.060-4.796, P = 0.035).

Conclusion: This study demonstrates that RT-induced low LMR is a valid prognostic marker for recurrence and survival in breast cancer patients undergoing RT.
Full Text
https://link.springer.com/article/10.1007/s10549-022-06601-8
DOI
10.1007/s10549-022-06601-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Goeun(박고은)
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Bae, Soong June(배숭준) ORCID logo https://orcid.org/0000-0002-0012-9694
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191530
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