Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival
Purpose. To investigate whether lymphocyte nadir induced by radiation is associated with survival and explore its underlying risk factors in patients with hepatocellular carcinoma (HCC). Methods. Total lymphocyte counts were collected from 184 HCC patients treated by radiotherapy (RT) with complete...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2019/9691067 |
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| author | Hai-Ge Zhang Ping Yang Tao Jiang Jian-Ying Zhang Xue-Juan Jin Yong Hu Jing Sun Shi-Suo Du Zhao-Chong Zeng |
| author_facet | Hai-Ge Zhang Ping Yang Tao Jiang Jian-Ying Zhang Xue-Juan Jin Yong Hu Jing Sun Shi-Suo Du Zhao-Chong Zeng |
| author_sort | Hai-Ge Zhang |
| collection | DOAJ |
| description | Purpose. To investigate whether lymphocyte nadir induced by radiation is associated with survival and explore its underlying risk factors in patients with hepatocellular carcinoma (HCC). Methods. Total lymphocyte counts were collected from 184 HCC patients treated by radiotherapy (RT) with complete follow-up. Associations between gross tumor volumes (GTVs) and radiation-associated parameters with lymphocyte nadir were evaluated by Pearson/Spearman correlation analysis and multiple linear regression. Kaplan–Meier analysis, log-rank test, as well as univariate and multivariate Cox regression were performed to assess the relationship between lymphocyte nadir and overall survival (OS). Results. GTVs and fractions were negatively related with lymphocyte nadir (p<0.001 and p=0.001, respectively). Lymphocyte nadir and Barcelona Clinic Liver Cancer (BCLC) stage were independent prognostic factors predicting OS of HCC patients (all p<0.001). Patients in the GTV ≤55.0 cc and fractions ≤16 groups were stratified by lymphocyte nadir, and the group with the higher lymphocyte counts (LCs) showed longer survival than the group with lower LCs (p<0.001 and p=0.006, respectively). Patient distribution significantly differed among the RT fraction groups according to BCLC stage (p<0.001). However, stratification of patients in the same BCLC stage by RT fractionation showed that the stereotactic body RT (SBRT) group achieved the best survival. Furthermore, there were significant differences in lymphocyte nadir among patients in the SBRT group. Conclusions. A lower lymphocyte nadir during RT was associated with worse survival among HCC patients. Smaller GTVs and fractions reduced the risk of lymphopenia. |
| format | Article |
| id | doaj-art-98f056008ab444ada2444a61e9f6ce34 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-98f056008ab444ada2444a61e9f6ce342025-02-03T01:22:00ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972019-01-01201910.1155/2019/96910679691067Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall SurvivalHai-Ge Zhang0Ping Yang1Tao Jiang2Jian-Ying Zhang3Xue-Juan Jin4Yong Hu5Jing Sun6Shi-Suo Du7Zhao-Chong Zeng8Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaPurpose. To investigate whether lymphocyte nadir induced by radiation is associated with survival and explore its underlying risk factors in patients with hepatocellular carcinoma (HCC). Methods. Total lymphocyte counts were collected from 184 HCC patients treated by radiotherapy (RT) with complete follow-up. Associations between gross tumor volumes (GTVs) and radiation-associated parameters with lymphocyte nadir were evaluated by Pearson/Spearman correlation analysis and multiple linear regression. Kaplan–Meier analysis, log-rank test, as well as univariate and multivariate Cox regression were performed to assess the relationship between lymphocyte nadir and overall survival (OS). Results. GTVs and fractions were negatively related with lymphocyte nadir (p<0.001 and p=0.001, respectively). Lymphocyte nadir and Barcelona Clinic Liver Cancer (BCLC) stage were independent prognostic factors predicting OS of HCC patients (all p<0.001). Patients in the GTV ≤55.0 cc and fractions ≤16 groups were stratified by lymphocyte nadir, and the group with the higher lymphocyte counts (LCs) showed longer survival than the group with lower LCs (p<0.001 and p=0.006, respectively). Patient distribution significantly differed among the RT fraction groups according to BCLC stage (p<0.001). However, stratification of patients in the same BCLC stage by RT fractionation showed that the stereotactic body RT (SBRT) group achieved the best survival. Furthermore, there were significant differences in lymphocyte nadir among patients in the SBRT group. Conclusions. A lower lymphocyte nadir during RT was associated with worse survival among HCC patients. Smaller GTVs and fractions reduced the risk of lymphopenia.http://dx.doi.org/10.1155/2019/9691067 |
| spellingShingle | Hai-Ge Zhang Ping Yang Tao Jiang Jian-Ying Zhang Xue-Juan Jin Yong Hu Jing Sun Shi-Suo Du Zhao-Chong Zeng Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival Canadian Journal of Gastroenterology and Hepatology |
| title | Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival |
| title_full | Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival |
| title_fullStr | Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival |
| title_full_unstemmed | Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival |
| title_short | Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival |
| title_sort | lymphopenia is associated with gross target volumes and fractions in hepatocellular carcinoma patients treated with external beam radiation therapy and also indicates worse overall survival |
| url | http://dx.doi.org/10.1155/2019/9691067 |
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