Patient‐specific modeling of radiation‐induced lymphopenia for head and neck cancer

作者：Jiaxin Li, Rahul D. Mali, Gregory N. Gan, C.E. Lominska, K. Guida, Aditya Juloori, M. Chen, Wangyao Li, Jufri Setianegara, Chao Wang, Yuting Lin, Qiang Li, Wei‐Qiang Chen, Hao Gao · 发表于：Medical Physics · 年份：2025 · DOI：10.1002/mp.17829 · 被引用次数：4 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Head and Neck Cancer Studies、Cancer Immunotherapy and Biomarkers

BACKGROUND: Radiation-induced lymphopenia (RIL) is a frequent complication in head and neck cancer (HNC) patients undergoing radiotherapy (RT), and its severity is associated with poorer survival outcomes. PURPOSE: This work aims to develop a patient-specific modeling method to simulate lymphocyte kinetics during and after RT and evaluate the lymphocyte-sparing effects across different RT treatment regimens. METHODS: A cohort of 17 HNC patients receiving unilateral irradiation with protons or photons were included in this study. The dose to circulating lymphocytes was calculated using the HEDOS model, considering lymph nodes on the irradiated side, the esophagus, auto-segmented bilateral carotid arteries and jugular veins, skeletal muscle, fat, skin, compact bone, spongy bone, red marrow, and other skeleton. A patient-specific model was developed to simulate lymphocyte kinetics that account for radiation-induced damage to both circulating lymphocytes and lymph nodes. The weekly absolute lymphocyte counts (ALC) before, during and after RT, were assembled to estimate the patient-specific parameters. Four different RT treatment regimens-conventional fractionation, hypofractionation, stereotactic body radiotherapy (SBRT), and FLASH-were evaluated to compare their lymphocyte-sparing effects. RESULTS: Patients treated with protons had 17.1% less grade 3 and 4 RIL compared to photons. The mean dose to circulating lymphocytes was 1.28 ± 0.37 Gy(RBE) for proton therapy and 3.12 ± 0.75...