Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy
Abstract Background We analyzed the relationship among peripheral blood lymphocytes, exposed sternum and vertebra body bone marrow (BM), and overall survival (OS) to find BM dosimetric parameters of lymphopenia during chemoradiotherapy (CRT) for patients with esophageal squamous cell carcinoma (ESCC...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-09-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.4131 |
| _version_ | 1828945789664100352 |
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| author | Qian Wang Qingtao Qiu Zicheng Zhang Jing Zhang Guanghui Yang Chengxin Liu Baosheng Li |
| author_facet | Qian Wang Qingtao Qiu Zicheng Zhang Jing Zhang Guanghui Yang Chengxin Liu Baosheng Li |
| author_sort | Qian Wang |
| collection | DOAJ |
| description | Abstract Background We analyzed the relationship among peripheral blood lymphocytes, exposed sternum and vertebra body bone marrow (BM), and overall survival (OS) to find BM dosimetric parameters of lymphopenia during chemoradiotherapy (CRT) for patients with esophageal squamous cell carcinoma (ESCC). Methods We examined 476 ESCC patients from January 2012 to January 2015, all of whom received concurrent or sequential CRT. Absolute lymphocyte counts (ALC) during radiotherapy (RT) of each patient were collected from the routine workup at the following RT times: pretreatment ALC (ALC0), at 1–5, 6–10, 11–15, 16–20, and 21–25, and more than 26 sessions (called ALC1–6, respectively). The sternum and vertebral body BM were delineated in accordance with uniform standards, and the irradiated volumes were calculated by dose‐volume histograms (DVH). The Kaplan–Meier method and Cox proportional hazards regression were used to analyze the survival of the patients. Comparisons of DVH were performed using the Mann–Whitney U test or two‐sample t‐test where appropriate. Results A relative volume of sternum BM irradiated by more than 20 Gy could clearly affect the peripheral blood lymphocytes. The V20 of sternum BM and V50 of vertebra body BM were related to the OS of the patients, and the level of ALC2 (at 6–10 times of RT) could predict the outcomes of patients. The Cox regression analyses showed that the 218 patients with ALC2 ≥ 0.8 × 109/L had a significantly higher OS (47.0 months vs. 30.9 months, p < 0.0001) than the 258 patients with ALC2 < 0.8×109/L. Conclusion In patients with ESCC, the relative volume of sternum BM irradiated by more than 20 Gy was associated with lymphocytes. Patients with ALC2 ≥ 0.8 × 109/L had a significantly higher OS. The V20 of the sternum BM, the V50 of the vertebra body BM, and the level of ALC2 were significant prognostic factors in patients with ESCC. |
| first_indexed | 2024-12-14T04:59:25Z |
| format | Article |
| id | doaj.art-dbbd4faa6d474833be4ded1324bf9c44 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-14T04:59:25Z |
| publishDate | 2021-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-dbbd4faa6d474833be4ded1324bf9c442022-12-21T23:16:16ZengWileyCancer Medicine2045-76342021-09-0110175847585810.1002/cam4.4131Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapyQian Wang0Qingtao Qiu1Zicheng Zhang2Jing Zhang3Guanghui Yang4Chengxin Liu5Baosheng Li6Cheeloo College of MedicineShandong University Jinan ChinaDepartment of Radiation Oncology Shandong Cancer Hospital and InstituteShandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaDepartment of Radiation Oncology Shenzhen Traditional Chinese Medicine HospitalThe Fourth Clinical Medical of Guangzhou University of Chinese Medicine Shenzhen Guangdong ChinaCheeloo College of MedicineShandong University Jinan ChinaCheeloo College of MedicineShandong University Jinan ChinaCheeloo College of MedicineShandong University Jinan ChinaDepartment of Radiation Oncology Shandong Cancer Hospital and InstituteShandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaAbstract Background We analyzed the relationship among peripheral blood lymphocytes, exposed sternum and vertebra body bone marrow (BM), and overall survival (OS) to find BM dosimetric parameters of lymphopenia during chemoradiotherapy (CRT) for patients with esophageal squamous cell carcinoma (ESCC). Methods We examined 476 ESCC patients from January 2012 to January 2015, all of whom received concurrent or sequential CRT. Absolute lymphocyte counts (ALC) during radiotherapy (RT) of each patient were collected from the routine workup at the following RT times: pretreatment ALC (ALC0), at 1–5, 6–10, 11–15, 16–20, and 21–25, and more than 26 sessions (called ALC1–6, respectively). The sternum and vertebral body BM were delineated in accordance with uniform standards, and the irradiated volumes were calculated by dose‐volume histograms (DVH). The Kaplan–Meier method and Cox proportional hazards regression were used to analyze the survival of the patients. Comparisons of DVH were performed using the Mann–Whitney U test or two‐sample t‐test where appropriate. Results A relative volume of sternum BM irradiated by more than 20 Gy could clearly affect the peripheral blood lymphocytes. The V20 of sternum BM and V50 of vertebra body BM were related to the OS of the patients, and the level of ALC2 (at 6–10 times of RT) could predict the outcomes of patients. The Cox regression analyses showed that the 218 patients with ALC2 ≥ 0.8 × 109/L had a significantly higher OS (47.0 months vs. 30.9 months, p < 0.0001) than the 258 patients with ALC2 < 0.8×109/L. Conclusion In patients with ESCC, the relative volume of sternum BM irradiated by more than 20 Gy was associated with lymphocytes. Patients with ALC2 ≥ 0.8 × 109/L had a significantly higher OS. The V20 of the sternum BM, the V50 of the vertebra body BM, and the level of ALC2 were significant prognostic factors in patients with ESCC.https://doi.org/10.1002/cam4.4131bone marrowchemoradiotherapyesophageal cancerlymphocytes |
| spellingShingle | Qian Wang Qingtao Qiu Zicheng Zhang Jing Zhang Guanghui Yang Chengxin Liu Baosheng Li Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy Cancer Medicine bone marrow chemoradiotherapy esophageal cancer lymphocytes |
| title | Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy |
| title_full | Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy |
| title_fullStr | Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy |
| title_full_unstemmed | Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy |
| title_short | Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy |
| title_sort | bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy |
| topic | bone marrow chemoradiotherapy esophageal cancer lymphocytes |
| url | https://doi.org/10.1002/cam4.4131 |
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