Neoadjuvant chemoradiotherapy induced lymphopenia in gastric cancer and associations with spleen dosimetry and survival outcomes

作者：Ji-Jin Wang, S. Han, Yan Jin, Ming Jing, Wenjing Xu, Hengwen Sun, Zhiwei Zhou, Yujing Zhang · 发表于：Clinical and Translational Radiation Oncology · 年份：2023 · DOI：10.1016/j.ctro.2023.100617 · 被引用次数：3 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Head and Neck Cancer Studies、Gastric Cancer Management and Outcomes

Background: Few studies concentrate on spleen dosimetry of radiotherapy for gastric cancer (GC). Although there is no consensus on the spleen dose-volume threshold for lymphopenia, several studies indicated that the higher the spleen dose, the higher the risk of lymphopenia. This study aimed to identify the appropriate spleen dosimetric parameters for predicting grade 4 + lymphopenia in patients with locally advanced GC. Material and methods: A total of 295 patients treated with nCRT and nChT from June 2013 to December 2021 at two major centers were included, of whom 220 were assigned to the training cohort and 75 to the external validation cohort. Results: to < 84.5% could decrease the incidence of grade 4 + lymphopenia by 35.7%. The predictive effectiveness of the multivariable model in the training and external validation cohorts was 0.880 and 0.737, respectively. Conclusion: to < 84.5% may indirectly improve outcomes through lymphocyte preservation.