Cargando…
Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation
PURPOSE: Radiation-induced lymphopenia is a well-recognized factor for tumor control and survival in patients with cancer. This study aimed to determine the role of radiation dose to the thymus and thoracic duct on radiation-induced lymphopenia. METHODS AND MATERIALS: Patients with primary lung canc...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692302/ https://www.ncbi.nlm.nih.gov/pubmed/38047216 http://dx.doi.org/10.1016/j.adro.2023.101260 |
_version_ | 1785152914346475520 |
---|---|
author | Zhang, Jinliang Yang, Li Li, Hui Chan, Jeff W. Lee, Eric K.W. Liu, Min Ma, Lingyu Liu, Qin Jin, Jian-Yue Fu, Pingfu Xu, Zhiyuan Kong, Feng-Ming (Spring) |
author_facet | Zhang, Jinliang Yang, Li Li, Hui Chan, Jeff W. Lee, Eric K.W. Liu, Min Ma, Lingyu Liu, Qin Jin, Jian-Yue Fu, Pingfu Xu, Zhiyuan Kong, Feng-Ming (Spring) |
author_sort | Zhang, Jinliang |
collection | PubMed |
description | PURPOSE: Radiation-induced lymphopenia is a well-recognized factor for tumor control and survival in patients with cancer. This study aimed to determine the role of radiation dose to the thymus and thoracic duct on radiation-induced lymphopenia. METHODS AND MATERIALS: Patients with primary lung cancer treated with thoracic radiation therapy between May 2015 and February 2020 with whole blood count data were eligible. Clinical characteristics, including age, gender, histology, stage, chemotherapy regimen, radiation dosimetry, and absolute lymphocyte count (ALC) were collected. The thymus and thoracic duct were contoured by one investigator for consistency and checked by one senior physician. The primary endpoint was radiation-induced decrease in lymphocytes, defined as the difference in ALC (DALC) before and after radiation therapy. RESULTS: The data of a total of 116 consecutive patients were retrospectively retrieved. Significant correlations were found between DALC and several clinical factors. These factors include stage, chemotherapy or concurrent chemoradiation, biologically effective dose (BED), mean lung dose, mean body dose, effective dose to immune cells (EDIC), mean thymus dose (MTD), and mean thoracic duct dose (MTDD) (all P < .05). Ridge regression showed that DALC = 0.0063 × BED + 0.0172 × EDIC + 0.0002 × MTD + 0.0147 × MTDD + 0.2510 (overall P = .00025 and F = 5.85). The combination model has the highest area under the curve of 0.77 (P < .001) when fitting the logistic regression model on DALC categorized as binary endpoint. The sensitivity and specificity of the combined model were 89% and 58%, respectively. CONCLUSIONS: This study demonstrated for the first time that radiation doses to the thymus and thoracic duct are strongly associated with radiation-induced lymphopenia patients with lung cancer. Further validation studies are needed to implement thymus and thoracic duct as organs at risk. |
format | Online Article Text |
id | pubmed-10692302 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-106923022023-12-03 Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation Zhang, Jinliang Yang, Li Li, Hui Chan, Jeff W. Lee, Eric K.W. Liu, Min Ma, Lingyu Liu, Qin Jin, Jian-Yue Fu, Pingfu Xu, Zhiyuan Kong, Feng-Ming (Spring) Adv Radiat Oncol Scientific Article PURPOSE: Radiation-induced lymphopenia is a well-recognized factor for tumor control and survival in patients with cancer. This study aimed to determine the role of radiation dose to the thymus and thoracic duct on radiation-induced lymphopenia. METHODS AND MATERIALS: Patients with primary lung cancer treated with thoracic radiation therapy between May 2015 and February 2020 with whole blood count data were eligible. Clinical characteristics, including age, gender, histology, stage, chemotherapy regimen, radiation dosimetry, and absolute lymphocyte count (ALC) were collected. The thymus and thoracic duct were contoured by one investigator for consistency and checked by one senior physician. The primary endpoint was radiation-induced decrease in lymphocytes, defined as the difference in ALC (DALC) before and after radiation therapy. RESULTS: The data of a total of 116 consecutive patients were retrospectively retrieved. Significant correlations were found between DALC and several clinical factors. These factors include stage, chemotherapy or concurrent chemoradiation, biologically effective dose (BED), mean lung dose, mean body dose, effective dose to immune cells (EDIC), mean thymus dose (MTD), and mean thoracic duct dose (MTDD) (all P < .05). Ridge regression showed that DALC = 0.0063 × BED + 0.0172 × EDIC + 0.0002 × MTD + 0.0147 × MTDD + 0.2510 (overall P = .00025 and F = 5.85). The combination model has the highest area under the curve of 0.77 (P < .001) when fitting the logistic regression model on DALC categorized as binary endpoint. The sensitivity and specificity of the combined model were 89% and 58%, respectively. CONCLUSIONS: This study demonstrated for the first time that radiation doses to the thymus and thoracic duct are strongly associated with radiation-induced lymphopenia patients with lung cancer. Further validation studies are needed to implement thymus and thoracic duct as organs at risk. Elsevier 2023-05-01 /pmc/articles/PMC10692302/ /pubmed/38047216 http://dx.doi.org/10.1016/j.adro.2023.101260 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Scientific Article Zhang, Jinliang Yang, Li Li, Hui Chan, Jeff W. Lee, Eric K.W. Liu, Min Ma, Lingyu Liu, Qin Jin, Jian-Yue Fu, Pingfu Xu, Zhiyuan Kong, Feng-Ming (Spring) Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation |
title | Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation |
title_full | Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation |
title_fullStr | Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation |
title_full_unstemmed | Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation |
title_short | Dosimetric Effect of Thymus and Thoracic Duct on Radiation-Induced Lymphopenia in Patients With Primary Lung Cancer Who Received Thoracic Radiation |
title_sort | dosimetric effect of thymus and thoracic duct on radiation-induced lymphopenia in patients with primary lung cancer who received thoracic radiation |
topic | Scientific Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692302/ https://www.ncbi.nlm.nih.gov/pubmed/38047216 http://dx.doi.org/10.1016/j.adro.2023.101260 |
work_keys_str_mv | AT zhangjinliang dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT yangli dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT lihui dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT chanjeffw dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT leeerickw dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT liumin dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT malingyu dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT liuqin dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT jinjianyue dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT fupingfu dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT xuzhiyuan dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation AT kongfengmingspring dosimetriceffectofthymusandthoracicductonradiationinducedlymphopeniainpatientswithprimarylungcancerwhoreceivedthoracicradiation |