Risk factors for radiation induced lymphopenia in patients with breast cancer receiving adjuvant radiotherapy
Author
Chen, FangYu, Hao
Zhang, Hong
Nong, Yaqing
Wang, Qian
Jing, Haiman
Han, Ying
Wu, Junjie
Zhou, Zheng
Yang, Li
Xu, Zhiyuan
Liu, Yaya
Fu, Pingfu
Jin, Jian-Yue
Hsue, Victor
Chang, Amy
Kong, Feng-Ming Spring
Date
2021Journal
Annals of Translational MedicinePublisher
AME Publishing CompanyType
Article
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Background: This study aimed to investigate radiation-induced lymphopenia and its potential risk factors in patients with breast cancer receiving adjuvant radiotherapy. Methods: Breast cancer patients received adjuvant radiotherapy (RT) at our hospital with peripheral lymphocyte counts (PLC) at pre-and immediately after RT (post-RT) were eligible. The primary endpoints were any grade of lymphopenia post-RT and nadir-PLC/pre-PLC <0.8. Patient characteristics, tumor factors, and treatment factors were collected for risk assessment. Data are presented as mean and 95% confidence interval (CI) unless otherwise specified. Matched analysis was used to compare the statistical significance between different RT techniques. Results: A total of 735 consecutive patients met the study criteria. The mean PLC was 1.58×109/L before and 0.99×109/L post-RT (P<0.001). At the end of RT, 60.5% of patients had lymphopenia. Univariate and multivariable logistic analyses showed that RT technique involving RapidArc, mean lung dose, and chemotherapy were significant risk factors (P<0.05) for lymphopenia. RT technique was the only significant risk factor (P<0.05) for nadir-PLC/pre-PLC <0.8. Patients treated with RapidArc had a significantly greater reduction of PLC along with greater V5 of the lungs, even after matching mean lung dose and radiated volume. Conclusions: Lymphopenia is common in patients with breast cancer after adjuvant RT. RT technique is the only significant factor for lymphopenia and nadir-PLC/pre-PLC <0.8, suggesting the significance of RT technique choice to minimize lymphopenia and improve treatment outcomes.Rights/Terms
2021 Annals of Translational Medicine. All rights reserved.Identifier to cite or link to this item
http://hdl.handle.net/10713/16687ae974a485f413a2113503eed53cd6c53
10.21037/atm-21-2150
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