治疗相关性淋巴细胞减少症与 III 期非小细胞肺癌。
Treatment-related lymphopenia in patients with stage III non-small-cell lung cancer.
机构信息
Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
Cancer Invest. 2013 Mar;31(3):183-8. doi: 10.3109/07357907.2013.767342. Epub 2013 Feb 22.
Abstract
BACKGROUND
This study sought to estimate the severity, etiology, and clinical importance of treatment-related lymphopenia in patients with stage III non-small-cell lung cancer.
METHODS
Serial lymphocyte counts and survival were analyzed retrospectively in 47 patients accounting for known prognostic factors.
RESULTS
Total lymphocyte counts (TLCs) were normal before therapy and did not change following neoadjuvant chemotherapy. Following radiation, TLC fell by 67% (median 500 cells/mm(3), p <.00001). Multivariate analysis revealed an association between severe TLC and survival (HR 1.70, 95% CI: 0.8-3.6).
CONCLUSIONS
Rapid and severe lymphopenia occurred in 50% of patients following radiation which was associated with reduced survival.
摘要
背景
本研究旨在评估 III 期非小细胞肺癌患者治疗相关性淋巴细胞减少症的严重程度、病因和临床意义。
方法
对 47 例已知预后因素的患者进行回顾性分析，检测其淋巴细胞计数和生存情况。
结果
治疗前总淋巴细胞计数（TLC）正常，新辅助化疗后无变化。放疗后，TLC 下降 67%（中位数 500 细胞/mm³，p<0.00001）。多变量分析显示，严重的 TLC 与生存相关（HR 1.70，95%CI：0.8-3.6）。
结论
放疗后 50%的患者出现快速且严重的淋巴细胞减少症，与生存降低有关。
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本文引用的文献
1
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Cancer Invest. 2013 Feb;31(2):140-4. doi: 10.3109/07357907.2012.762780.
2
The association between treatment-related lymphopenia and survival in newly diagnosed patients with resected adenocarcinoma of the pancreas.
Cancer Invest. 2012 Oct;30(8):571-6. doi: 10.3109/07357907.2012.700987. Epub 2012 Jul 19.
3
Strengths and weaknesses of immunotherapy for advanced non-small-cell lung cancer: a meta-analysis of 12 randomized controlled trials.
PLoS One. 2012;7(3):e32695. doi: 10.1371/journal.pone.0032695. Epub 2012 Mar 5.
4
Active-specific immunotherapy for non-small cell lung cancer.
J Thorac Dis. 2011 Jun;3(2):105-14. doi: 10.3978/j.issn.2072-1439.2010.12.06.
5
Immunosuppression in patients with high-grade gliomas treated with radiation and temozolomide.
Clin Cancer Res. 2011 Aug 15;17(16):5473-80. doi: 10.1158/1078-0432.CCR-11-0774. Epub 2011 Jul 7.
6
Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer.
Cancer Res Treat. 2011 Mar;43(1):32-41. doi: 10.4143/crt.2011.43.1.32. Epub 2011 Mar 31.
7
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Clin Cancer Res. 2011 Jul 1;17(13):4296-308. doi: 10.1158/1078-0432.CCR-10-2557. Epub 2011 Apr 8.
8
Colorectal cancer prognosis depends on T-cell infiltration and molecular characteristics of the tumor.
Mod Pathol. 2011 May;24(5):671-82. doi: 10.1038/modpathol.2010.234. Epub 2011 Jan 14.
9
Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas.
Cancer Res. 2009 Jul 1;69(13):5383-91. doi: 10.1158/0008-5472.CAN-08-3845. Epub 2009 Jun 23.
10
Immune surveillance of tumors.
J Clin Invest. 2007 May;117(5):1137-46. doi: 10.1172/JCI31405.
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