Takeda Kazuya, Umezawa Rei, Yamamoto Takaya, Takahashi Noriyoshi, Suzuki Yu, Kishida Keita, Omata So, Jingu Keiichi
Department of Radiation Oncology Tohoku University Graduate School of Medicine Sendai Japan.
Department of Radiation Oncology South Miyagi Medical Center Ogawara Japan.
Precis Radiat Oncol. 2024 Feb 29;8(1):22-29. doi: 10.1002/pro6.1221. eCollection 2024 Mar.
We retrospectively analyzed breast cancer patients who received adjuvant radiotherapy to determine the incidence of lymphocytopenia and its risk factors.
We reviewed 812 patients with breast cancer who received postoperative radiotherapy. Patients were divided into two groups based on the use of chemotherapy, and a generalized linear regression model was used to explore predictive factors for grade 2 or higher lymphocytopenia. We also examined the effect of lymphocytopenia on overall survival.
Grade 2 or higher lymphocytopenia was observed in 19.4% of patients who did not receive chemotherapy and 45.1% of patients who received chemotherapy. In multivariate analysis, bilateral disease, regional lymph node irradiation, and baseline lymphocytopenia were associated with lymphocytopenia in patients who did not receive cytotoxic chemotherapy. Regional lymph node irradiation, baseline lymphocytopenia, use of antimetabolites, and use of molecular-targeted agents were associated with lymphocytopenia in patients treated with chemotherapy. In the survival analysis, lymphocytopenia was associated with worse overall survival only in patients treated with cytotoxic chemotherapy ( = 0.039), and not in patients who did not receive chemotherapy ( = 0.77).
The analysis revealed the incidence and risk factors of lymphocytopenia after postoperative radiotherapy in patients with breast cancer.
我们回顾性分析接受辅助放疗的乳腺癌患者，以确定淋巴细胞减少症的发生率及其危险因素。
我们回顾了812例接受术后放疗的乳腺癌患者。根据化疗的使用情况将患者分为两组，并使用广义线性回归模型来探索2级或更高级别淋巴细胞减少症的预测因素。我们还研究了淋巴细胞减少症对总生存期的影响。
未接受化疗的患者中有19.4%出现2级或更高级别淋巴细胞减少症，接受化疗的患者中有45.1%出现该症状。在多变量分析中，双侧病变、区域淋巴结照射和基线淋巴细胞减少症与未接受细胞毒性化疗的患者的淋巴细胞减少症相关。区域淋巴结照射、基线淋巴细胞减少症、抗代谢药物的使用以及分子靶向药物的使用与接受化疗的患者的淋巴细胞减少症相关。在生存分析中，淋巴细胞减少症仅与接受细胞毒性化疗的患者的总生存期较差相关（P = 0.039），而与未接受化疗的患者无关（P = 0.77）。
该分析揭示了乳腺癌患者术后放疗后淋巴细胞减少症的发生率和危险因素。
