Department of Radiotherapy, Affiliated Hospital of Qinghai University, Xining, China.
Medicine (Baltimore). 2024 May 31;103(22):e38355. doi: 10.1097/MD.0000000000038355.
To investigate T lymphocyte, neutrophil/lymphocyte ratio (NLR) and their impact on patients with radiation-induced oral mucositis (RIOM) after intensity-modulated radiotherapy for head and neck cancer. The clinical data of 148 patients diagnosed with head and neck cancer from January 2016 to January 2019 were retrospectively analyzed. Patients were divided into RIOM group (n = 42 cases) and non-RIOM group (n = 106 cases), based on whether they developed RIOM after intensity-modulated radiation therapy. The T lymphocyte and NLR of the 2 groups were analyzed before and after treatment; The correlation between T lymphocyte and NLR in RIOM group was analyzed. We used RTOG grading system to evaluate and scale the RIOM. The relationship between the grade of RIOM, T lymphocyte and NLR in RIOM group was analyzed. After treatment, the proportion of CD3 +, CD4 +, and CD8 + T lymphocytes in the 2 groups after treatment were decreased, and the RIOM group was significantly lower than non-RIOM group, P < .05. NLR in RIOM group was significantly higher than that in non-RIOM group, P < .05. The data of overall survival showed no significant differences between 2 groups (HR = 0.82, 95% CI: 0.43-1.59). Compared with RIOM group, patients in non-RIOM group showed a longer progress-free survival (HR = 0.57, 95% CI: 0.33-0.99). In RIOM group, NLR was negatively correlated with CD3 + (r = -0.433, P = .004), CD4 + (r = -0.644, P < .001) and CD8 + T cells (r = -0.665, P < .001). RIOM was positively correlated with NLR (R = 0.621, P < .001), negatively correlated with CD4 + T cell ratio (r = -0.449, P = .003) and CD8 + T cell ratio (r = -0.307, P = .048), but RIOM did not correlate with CD3 + T cell ratio (r = -0.225, P = .152). For patients with RIOM after intensity-modulated radiotherapy for head and neck cancer, T lymphocyte showed a downward trend, and NLR showed an upward trend. In addition, T lymphocyte and NLR are closely related to the RIOM, indicating that clinicians should be aware of the importance of T lymphocyte and NLR on patients received radiotherapy.
探讨调强放疗后头颈癌患者 T 淋巴细胞、中性粒细胞/淋巴细胞比值（NLR）及其对放射性口腔黏膜炎（RIOM）的影响。回顾性分析 2016 年 1 月至 2019 年 1 月诊断为头颈癌的 148 例患者的临床资料。根据调强放疗后是否发生 RIOM，将患者分为 RIOM 组（n=42 例）和非 RIOM 组（n=106 例）。分析两组治疗前后 T 淋巴细胞和 NLR；分析 RIOM 组 T 淋巴细胞与 NLR 的相关性。采用 RTOG 分级系统评价 RIOM 并分级。分析 RIOM 组 RIOM 分级、T 淋巴细胞和 NLR 之间的关系。治疗后，两组治疗后 CD3+、CD4+、CD8+T 淋巴细胞比例均下降，RIOM 组明显低于非 RIOM 组，P<.05。RIOM 组 NLR 明显高于非 RIOM 组，P<.05。总生存数据显示两组间无显著差异（HR=0.82，95%CI：0.43-1.59）。与 RIOM 组相比，非 RIOM 组患者无进展生存期更长（HR=0.57，95%CI：0.33-0.99）。RIOM 组 NLR 与 CD3+呈负相关（r=-0.433，P=0.004）、CD4+呈负相关（r=-0.644，P<.001）、CD8+T 细胞呈负相关（r=-0.665，P<.001）。RIOM 与 NLR 呈正相关（R=0.621，P<.001），与 CD4+T 细胞比例呈负相关（r=-0.449，P=0.003）、与 CD8+T 细胞比例呈负相关（r=-0.307，P=0.048），但与 CD3+T 细胞比例无相关性（r=-0.225，P=0.152）。对于接受调强放疗后发生 RIOM 的患者，T 淋巴细胞呈下降趋势，NLR 呈上升趋势。此外，T 淋巴细胞和 NLR 与 RIOM 密切相关，提示临床医生应重视放疗患者 T 淋巴细胞和 NLR 的重要性。
