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Effect of HFRT and CFRT on peripheral blood lymphocytes in patients with breast cancer |
LIU Yihan1,2, YIN Haitao2, ZHOU Yun2, ZHOU Chong2, REN Hongrong2 |
1. Graduate School of Xuzhou Medical University, Xuzhou 221000 China; 2. Department of Radiotherapy, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou 221000 China |
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Abstract Objective To investigate the effect of different fractionated radiotherapy of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) on peripheral blood lymphocytes in patients with breast cancer. Methods This retrospective analysis enrolled 40 patients with early breast cancer who underwent radiotherapy post breast conserving surgery in Xuzhou Central Hospital from November 2019 to August 2021. The patients were randomly divided into the observation group (HFRT, n = 20) and the control group (CFRT, n = 20). Changes in peripheral blood lymphocyte count (PLC) before and during radiotherapy were compared between the two groups. Results The baseline PLC was comparable between the observation group and the control group (1.53 ± 0.54 vs 1.64 ± 0.56, P > 0.05). In both groups, the PLC declined steadily during radiotherapy, and the incidence of lymphopenia in the observation group was lower than that in the control group (32.5% vs 50.0%, P > 0.05); the PLC nadir was higher in the observation group than in the control group (0.91 ± 0.28 vs 0.55 ± 0.22, P < 0.001). The ratio of the PLC nadir during treatment to baseline was significantly higher in the observation group than in the control group (0.64 ± 0.24 vs 0.38 ± 0.21, P < 0.05). Conclusion Patients with breast cancer receiving HFRT show a lower risk of radiation-induced lymphopenia versus those receiving CFRT.
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Received: 17 October 2021
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[1] 中国医师协会放射肿瘤治疗医师分会. 乳腺癌放射治疗指南(中国医师协会2020版)[J]. 中华放射肿瘤学杂志, 2021, 30(4): 321-342. DOI: 10.3760/cma.j.cn113030-20210107-00010. Radiotherapy Oncologist Branch of Chinese Medical Association. Guidelines for radiotherapy of breast cancer (Chinese Medical Doctor Association 2020 edition)[J]. Chin J Radiat Oncol, 2021, 30(4): 321-342. DOI: 10.3760/cma.j.cn113030-20210107-00010. [2] 翟静, 张鹏程, 耿凯, 等. 乳腺癌应用保乳术辅助放疗的临床疗效观察[J]. 中国辐射卫生,2014,23(3):270-272. DOI: 10.13491/j.cnki.issn.1004-714X.2014.03.035 Zhai J, Zhang PC, Geng K, et al. The observation on the clinical curative effect of breast conserving surgery with adjuvant radiotherapy in breast cancer[J]. Chin J Radiol Health, 2014, 23(3): 270-272. DOI: 10.13491/j.cnki.issn.1004-714X.2014.03.035 [3] Campian JL, Ye XB, Brock M, et al. Treatment-related lymphopenia in patients with stage III non-small-cell lung cancer[J]. Cancer Invest, 2013, 31(3): 183-188. DOI: 10.3109/07357907.2013.767342 [4] Grossman SA, Ye XB, Lesser G, et al. Immunosuppression in patients with high-grade gliomas treated with radiation and temozolomide[J]. Clin Cancer Res, 2011, 17(16): 5473-5480. DOI: 10.1158/1078-0432.CCR-11-0774 [5] Wild AT, Herman JM, Dholakia AS, et al. Lymphocyte-sparing effect of stereotactic body radiation therapy in patients with unresectable pancreatic cancer[J]. Int J Radiat Oncol Biol Phys, 2016, 94(3): 571-579. DOI: 10.1016/j.ijrobp.2015.11.026 [6] Venkatesulu BP, Mallick S, Lin SH, et al. A systematic review of the influence of radiation-induced lymphopenia on survival outcomes in solid tumors[J]. Crit Rev Oncol Hematol, 2018, 123: 42-51. DOI: 10.1016/j.critrevonc.2018.01.003 [7] Zhuang Y, Yuan BY, Chen GW, et al. Association between circulating lymphocyte populations and outcome after stereotactic body radiation therapy in patients with hepatocellular carcinoma[J]. Front Oncol, 2019, 9: 896. DOI: 10.3389/fonc.2019.00896 [8] Saito T, Toya R, Matsuyama T, et al. Dosimetric predictors of treatment-related lymphopenia induced by palliative radiotherapy: predictive ability of dose-volume parameters based on body surface contour[J]. Radiol Oncol, 2017, 51(2): 228-234. DOI: 10.1515/raon-2016-0050 [9] Shiraishi Y, Fang P, Xu C, et al. Severe lymphopenia during neoadjuvant chemoradiation for esophageal cancer: a propensity matched analysis of the relative risk of proton versus photon-based radiation therapy[J]. Radiother Oncol, 2018, 128(1): 154-160. DOI: 10.1016/j.radonc.2017.11.028 [10] Ellsworth SG, Yalamanchali A, Zhang H, et al. Comprehensive analysis of the kinetics of radiation-induced lymphocyte loss in patients treated with external beam radiation therapy[J]. Radiat Res, 2019, 193(1): 73-81. DOI: 10.1667/RR15367.1 [11] Van Rossum PSN, Deng W, Routman DM, et al. Prediction of severe lymphopenia during chemoradiation therapy for esophageal cancer: development and validation of a pretreatment nomogram[J]. Pract Radiat Oncol, 2020, 10(1): e16-e26. DOI: 10.1016/j.prro.2019.07.010 [12] Mohme M, Riethdorf S, Pantel K. Circulating and disseminated tumour cells-mechanisms of immune surveillance and escape[J]. Nat Rev Clin Oncol, 2017, 14(3): 155-167. DOI: 10.1038/nrclinonc.2016.144 [13] Zhang XL, Kim S, Hundal J, et al. Breast cancer neoantigens can induce CD8+ T-cell responses and antitumor immunity[J]. Cancer Immunol Res, 2017, 5(7): 516-523. DOI: 10.1158/2326-6066.CIR-16-0264 [14] Meyer KK. Radiation-induced lymphocyte-immune deficiency. A factor in the increased visceral metastases and decreased hormonal responsiveness of breast cancer[J]. Arch Surg, 1970, 101(2): 114-121. DOI: 10.1001/archsurg.1970.01340260018003 [15] Yovino S, Kleinberg L, Grossman SA, et al. The etiology of treatment-related lymphopenia in patients with malignant gliomas: modeling radiation dose to circulating lymphocytes explains clinical observations and suggests methods of modifying the impact of radiation on immune cells[J]. Cancer Invest, 2013, 31(2): 140-144. DOI: 10.3109/07357907.2012.762780 [16] Maclennan ICM, Kay HEM. Analysis of treatment in childhood leukemia. IV. The critical association between dose fractionation and immunosuppression induced by cranial irradiation[J]. Cancer, 1978, 41(1): 108-111. DOI: 10.1002/1097-0142(197801)41:1<108::aid-cncr2820410116>3.0.co;2-z [17] 张琳, 刘东仁, 侯殿俊, 等. 不同剂量X射线照射对介入放射工作人员离体外周血淋巴细胞凋亡率的影响[J]. 中国辐射卫生,2019,28(4):368-370. DOI: 10.13491/j.issn.1004-714X.2019.04.005 Zhang L, Liu DR, Hou DJ, et al. Effects of different doses of X-ray irradiation on the apoptosis rate of peripheral blood lymphocytes in interventional radiology workers[J]. Chin J Radiol Health, 2019, 28(4): 368-370. DOI: 10.13491/j.issn.1004-714X.2019.04.005
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