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    Risk factors for radiation induced lymphopenia in patients with breast cancer receiving adjuvant radiotherapy

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    Author
    Chen, Fang
    Yu, 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
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    Date
    2021
    Journal
    Annals of Translational Medicine
    Publisher
    AME Publishing Company
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.21037/atm-21-2150
    Abstract
    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.
    Keyword
    Lymphopenia
    RapidArc
    breast cancer
    radiotherapy technique
    risk factors
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16687
    ae974a485f413a2113503eed53cd6c53
    10.21037/atm-21-2150
    Scopus Count
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