Zhang Haojiong, Gao Jing, Hu Jiyi, Hu Weixu, Huang Qingting, Kong Lin
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China.
Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.
Front Oncol. 2025 Jun 16;15:1543718. doi: 10.3389/fonc.2025.1543718. eCollection 2025.
Bone and soft tissue tumors present unique therapeutic challenges due to their heterogeneity and poor prognosis to standard treatments. Particle therapy offers improved dose distribution and potentially higher relative biological effectiveness, however, its immunological effects in patients remain poorly understood. Investigating peripheral immune cell changes could offer valuable insights for integrating immunotherapies and optimizing treatment outcomes.
In this observational study, we enrolled 12 patients with head and neck bone and soft tissue tumors treated at our center between November 1, 2022, and November 1, 2024. Treatment modalities included proton or carbon-ion radiotherapy, with or without chemotherapy, targeted therapy, or immunotherapy. Peripheral blood samples were collected both before and after the completion of radiotherapy. Hematologic assessments were conducted, including total lymphocyte counts and immunophenotyping of CD3+, CD4+, CD8+, and other lymphocyte subsets. Statistical analyses, including paired Student's t-test, Wilcoxon signed-rank tests and univariate analysis, were performed to investigate associations between lymphocyte changes and clinical factors.
Minor reductions were noted in CD3 and CD4 T cell subsets, accompanied by a small increase in CD3CD4CD8 subsets. Even after excluding the patient who received immunotherapy, the observed trend in lymphocyte counts and subset changes remained consistent. This finding suggests that, compared with conventional photon radiotherapy, particle therapy may better preserve immune function. Remarkably, all patients were alive and showed no evidence of disease progression during the study period.
Particle therapy in patients with head and neck bone and soft tissue tumors induces modest immunological alterations, suggesting it may preserve immune function more effectively than conventional photon radiotherapy. These preliminary findings from our small cohort support further research into combining particle therapy with immunomodulatory strategies, potentially enhancing clinical outcomes and expanding therapeutic options for these challenging malignancies.
骨与软组织肿瘤因其异质性以及对标准治疗预后不佳而带来独特的治疗挑战。粒子疗法可改善剂量分布，并可能具有更高的相对生物效应，然而，其对患者的免疫作用仍知之甚少。研究外周免疫细胞变化可为整合免疫疗法及优化治疗结果提供有价值的见解。
在这项观察性研究中，我们纳入了2022年11月1日至2024年11月1日期间在本中心接受治疗的12例头颈部骨与软组织肿瘤患者。治疗方式包括质子或碳离子放疗，联合或不联合化疗、靶向治疗或免疫治疗。放疗结束前后均采集外周血样本。进行血液学评估，包括总淋巴细胞计数以及CD3 +、CD4 +、CD8 +和其他淋巴细胞亚群的免疫表型分析。进行统计分析，包括配对t检验、Wilcoxon符号秩检验和单因素分析，以研究淋巴细胞变化与临床因素之间的关联。
CD3和CD4 T细胞亚群略有减少，同时CD3CD4CD8亚群略有增加。即使排除接受免疫治疗的患者，观察到的淋巴细胞计数和亚群变化趋势仍保持一致。这一发现表明，与传统光子放疗相比，粒子疗法可能能更好地保留免疫功能。值得注意的是，在研究期间所有患者均存活且无疾病进展迹象。
对头颈部骨与软组织肿瘤患者进行粒子疗法会引起适度的免疫改变，这表明它可能比传统光子放疗更有效地保留免疫功能。我们小样本队列的这些初步发现支持进一步研究将粒子疗法与免疫调节策略相结合，这可能会改善临床结果并为这些具有挑战性的恶性肿瘤拓展治疗选择。
