Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France.
Radiation Oncology Department, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain.
Clin Transl Oncol. 2020 Nov;22(11):2040-2048. doi: 10.1007/s12094-020-02345-3. Epub 2020 Apr 13.
Although the chemotherapy-induced depletion of circulating white blood cells (WBC) is well recognized, the impact of exclusive radiotherapy (RT) on the different subpopulations of WBC remains unexplored. This may be important for immunotherapy administrated in combination with radiation, especially in malignant tumors usually treated with RT or chemoradiotherapy (CRT), and characterized by a high mutational burden, such as endometrial (EC) or cervical cancer (CC). We aimed to evaluate the impact of RT and CRT on circulating WBC in uterine cancers and its correlation with survival.
A total of 202 consecutive patients with uterine cancers treated with RT or CRT between 2009 and 2016 in a large European center and with available basal and post-treatment blood tests were retrospectively evaluated. EC and CC patients were analyzed separately. The differences between pre- and post- treatment WBC mean values were evaluated independently in patients treated with CRT and exclusive RT. Two-sided T test for paired samples and Kaplan-Meier curves were applied for analysis (p value < 0.05, SPSS v.23).
Among EC patients, 29 received CRT and 34 exclusive postoperative RT, while in CC cohort, 105 were treated with CRT and 34 with RT. In both cohorts, CRT affected significantly all WBC subtypes, whereas exclusive RT decreased only lymphocytes population (p = 0.000). Radiation-induced lymphopenia (RIL) had no impact on survival outcomes.
The selective depletion of lymphocytes after RT was significant in both EC and CC. Our results are of interest for further research on RIL and for design of immunotherapy-based clinical trials.
尽管人们已经认识到化疗引起的循环白细胞（WBC）耗竭，但单独放疗（RT）对 WBC 不同亚群的影响仍未得到探索。这对于与放疗联合使用的免疫治疗可能很重要，特别是在通常采用 RT 或放化疗（CRT）治疗的恶性肿瘤中，这些肿瘤具有高突变负担，例如子宫内膜（EC）或宫颈癌（CC）。我们旨在评估 RT 和 CRT 对子宫癌中循环 WBC 的影响及其与生存的相关性。
回顾性评估了 2009 年至 2016 年间在一家大型欧洲中心接受 RT 或 CRT 治疗且有可用基础和治疗后血液检查结果的 202 例连续子宫癌患者。分别分析了 EC 和 CC 患者。在 CRT 和单独 RT 治疗的患者中，分别评估了 CRT 和单独 RT 治疗前后 WBC 平均值的差异。采用双侧配对样本 T 检验和 Kaplan-Meier 曲线进行分析（p 值<0.05，SPSS v.23）。
在 EC 患者中，29 例接受 CRT，34 例接受单独术后 RT，而在 CC 队列中，105 例接受 CRT，34 例接受 RT。在两个队列中，CRT 均显著影响所有 WBC 亚型，而单独 RT 仅降低淋巴细胞群（p=0.000）。放疗诱导的淋巴细胞减少（RIL）对生存结果没有影响。
RT 后淋巴细胞的选择性耗竭在 EC 和 CC 中均很明显。我们的结果对于进一步研究 RIL 和设计基于免疫治疗的临床试验具有重要意义。
