Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer
Jared Deck,1 Marissa Hartley,1 Mohammad Akhter,1 Dongliang Wang,2 Jeffrey A Bogart,1 Michael D Mix1 1Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA; 2Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USACorrespon...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-05-01
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| Series: | Lung Cancer: Targets and Therapy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/effect-of-lymphopenia-on-tumor-response-and-clinical-outcomes-followin-peer-reviewed-fulltext-article-LCTT |
| _version_ | 1797822591778422784 |
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| author | Deck J Hartley M Akhter M Wang D Bogart JA Mix MD |
| author_facet | Deck J Hartley M Akhter M Wang D Bogart JA Mix MD |
| author_sort | Deck J |
| collection | DOAJ |
| description | Jared Deck,1 Marissa Hartley,1 Mohammad Akhter,1 Dongliang Wang,2 Jeffrey A Bogart,1 Michael D Mix1 1Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA; 2Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USACorrespondence: Jared Deck, Department of Radiation Oncology, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY, 13202, USA, Tel +1 (315)-464-5276, Email deckj@upstate.eduBackground: Prior studies suggest lymphopenia, systemic immune-inflammatory index, and tumor response all impact clinical outcomes in Stage III NSCLC. We hypothesized that tumor response after CRT would be associated with hematologic metrics and might predict clinical outcomes.Materials and Methods: Patients with stage III NSCLC treated at a single institution between 2011 and 2018 were retrospectively reviewed. Pre-treatment gross tumor volume (GTV) was recorded then reassessed at 1– 4 months post-CRT. Complete blood counts before, during and after treatment were recorded. Systemic immune-inflammation index (SII) was defined as neutrophil × platelet/lymphocyte. Overall survival (OS) and progression free survival (PFS) were calculated using Kaplan-Meier estimates, and compared with Wilcoxon tests. A multivariate analysis of hematologic factors impacting restricted mean survival was then performed using pseudovalue regression, accounting for other baseline factors.Results: 106 patients were included. After median follow-up of 24 months, median PFS and OS were 16 and 40 months, respectively. Within the multivariate model, baseline SII was associated with OS (p = 0.046) but not PFS (p = 0.09), and baseline ALC correlated with both PFS and OS (p = 0.03 and p = 0.02, respectively). Nadir ALC, nadir SII, and recovery SII were not associated with PFS or OS.Conclusion: In this cohort of patients with stage III NSCLC, baseline hematologic factors were associated with clinical outcomes including baseline ALC, baseline SII and recovery ALC. Disease response was not well correlated with hematologic factors or clinical outcomes.Keywords: lymphopenia, myelosuppression, chemoradiation, tumor response |
| first_indexed | 2024-03-13T10:10:20Z |
| format | Article |
| id | doaj.art-388efbfccb4f46eeb1b9c49a4a59936a |
| institution | Directory Open Access Journal |
| issn | 1179-2728 |
| language | English |
| last_indexed | 2024-03-13T10:10:20Z |
| publishDate | 2023-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Lung Cancer: Targets and Therapy |
| spelling | doaj.art-388efbfccb4f46eeb1b9c49a4a59936a2023-05-21T16:29:55ZengDove Medical PressLung Cancer: Targets and Therapy1179-27282023-05-01Volume 14475583858Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung CancerDeck JHartley MAkhter MWang DBogart JAMix MDJared Deck,1 Marissa Hartley,1 Mohammad Akhter,1 Dongliang Wang,2 Jeffrey A Bogart,1 Michael D Mix1 1Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA; 2Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USACorrespondence: Jared Deck, Department of Radiation Oncology, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY, 13202, USA, Tel +1 (315)-464-5276, Email deckj@upstate.eduBackground: Prior studies suggest lymphopenia, systemic immune-inflammatory index, and tumor response all impact clinical outcomes in Stage III NSCLC. We hypothesized that tumor response after CRT would be associated with hematologic metrics and might predict clinical outcomes.Materials and Methods: Patients with stage III NSCLC treated at a single institution between 2011 and 2018 were retrospectively reviewed. Pre-treatment gross tumor volume (GTV) was recorded then reassessed at 1– 4 months post-CRT. Complete blood counts before, during and after treatment were recorded. Systemic immune-inflammation index (SII) was defined as neutrophil × platelet/lymphocyte. Overall survival (OS) and progression free survival (PFS) were calculated using Kaplan-Meier estimates, and compared with Wilcoxon tests. A multivariate analysis of hematologic factors impacting restricted mean survival was then performed using pseudovalue regression, accounting for other baseline factors.Results: 106 patients were included. After median follow-up of 24 months, median PFS and OS were 16 and 40 months, respectively. Within the multivariate model, baseline SII was associated with OS (p = 0.046) but not PFS (p = 0.09), and baseline ALC correlated with both PFS and OS (p = 0.03 and p = 0.02, respectively). Nadir ALC, nadir SII, and recovery SII were not associated with PFS or OS.Conclusion: In this cohort of patients with stage III NSCLC, baseline hematologic factors were associated with clinical outcomes including baseline ALC, baseline SII and recovery ALC. Disease response was not well correlated with hematologic factors or clinical outcomes.Keywords: lymphopenia, myelosuppression, chemoradiation, tumor responsehttps://www.dovepress.com/effect-of-lymphopenia-on-tumor-response-and-clinical-outcomes-followin-peer-reviewed-fulltext-article-LCTTlymphopeniamyelosuppressionchemoradiationtumor response |
| spellingShingle | Deck J Hartley M Akhter M Wang D Bogart JA Mix MD Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer Lung Cancer: Targets and Therapy lymphopenia myelosuppression chemoradiation tumor response |
| title | Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer |
| title_full | Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer |
| title_fullStr | Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer |
| title_full_unstemmed | Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer |
| title_short | Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer |
| title_sort | effect of lymphopenia on tumor response and clinical outcomes following chemoradiotherapy in stage iii non small cell lung cancer |
| topic | lymphopenia myelosuppression chemoradiation tumor response |
| url | https://www.dovepress.com/effect-of-lymphopenia-on-tumor-response-and-clinical-outcomes-followin-peer-reviewed-fulltext-article-LCTT |
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