Radiation-Induced Lymphopenia and Its Impact on Survival in Patients with Brain Metastasis

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-08-09 DOI:10.3390/curroncol31080340

Naoko Ishida, Yukinori Matsuo, Junki Fukuda, Aritoshi Ri, Saori Tatsuno, Takuya Uehara, Masahiro Inada, Tomohiro Matsuura, Hiroshi Doi, Kiyoshi Nakamatsu, Makoto Hosono

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引用次数: 0

Abstract

Background: Differences in radiation-induced lymphopenia and prognosis between methods of radiotherapy (RT) for brain metastases remain unclear. Methods: In this retrospective analysis of patients who underwent whole-brain radiotherapy (WBRT) or stereotactic radiosurgery/radiotherapy (SRS/SRT) for brain metastases, baseline total lymphocyte count (TLC) data were obtained within 2 weeks before RT initiation. Follow-up TLC data were evaluated at 0–2, 2–4, and 4–8 weeks after RT completion. Persistent lymphopenia was defined as < 800/μL at any time point. Results: Overall, 138 RT courses in 128 patients were eligible (94 WBRT; 44 SRS/SRT). In the WBRT courses, the median baseline TLC was 1325/μL (IQR: 923–1799). Follow-up TLC decreased significantly to 946/μL (626–1316), 992/μL (675–1291), and 1075/μL (762–1435) (p < 0.001). SRS/SRT courses showed no significant TLC decrease. Multivariate analysis revealed female sex, prior RT, baseline TLC < 800/μL, and WBRT use were significantly associated with persistent lymphopenia. In the WBRT group, overall survival was significantly different between those with and without persistent lymphopenia (median, 2.6 and 6.1 months; p < 0.001). However, there was no significant difference in survival in the SRS/SRT group (p = 0.60). Conclusion: This study suggests SRS/SRT might be preferable for lymphocyte preservation in brain metastasis patients.

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放射诱导的淋巴细胞减少症及其对脑转移患者生存期的影响

背景：治疗脑转移瘤的放射治疗（RT）方法在放射诱导的淋巴细胞减少症和预后方面的差异仍不清楚。方法：对接受全脑放射治疗的患者进行回顾性分析：在这项对接受全脑放疗（WBRT）或立体定向放射手术/放疗（SRS/SRT）治疗脑转移瘤的患者进行的回顾性分析中，基线总淋巴细胞计数（TLC）数据是在放疗开始前两周内获得的。在 RT 结束后的 0-2、2-4 和 4-8 周评估随访 TLC 数据。在任何时间点淋巴细胞计数小于 800/μL 即为持续性淋巴细胞减少症。结果：共有 128 名患者的 138 个 RT 疗程符合条件（94 个 WBRT 疗程；44 个 SRS/SRT）。在WBRT疗程中，基线TLC中位数为1325/μL（IQR：923-1799）。随访TLC明显降低至946/μL (626-1316)、992/μL (675-1291)和1075/μL (762-1435)（p < 0.001）。SRS/SRT疗程未显示TLC显著下降。多变量分析显示，女性性别、既往接受过 RT、基线 TLC < 800/μL 和使用 WBRT 与持续性淋巴细胞减少症显著相关。在 WBRT 组中，有持续性淋巴细胞减少症和没有持续性淋巴细胞减少症的患者的总生存期有明显差异（中位 2.6 个月和 6.1 个月；P < 0.001）。然而，SRS/SRT 组的生存率没有明显差异（P = 0.60）。结论：本研究表明，SRS/SRT 可能是脑转移患者保留淋巴细胞的首选方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464