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:: Volume 21, Issue 3 (6-2023) ::
Int J Radiat Res 2023, 21(3): 421-425 Back to browse issues page
The effect of spleen dose-volume parameters on lymphopenia during chemoradiotherapy for pancreatic cancer
G.A. Inan , I.P. Aral , H.F. Ozturk , Z. Gani , S.A. Arslan , Y. Tezcan
Department of Radiation Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey , goncaaltinisikinan@gmail.com
Abstract:   (1237 Views)
Background: We aimed to investigate the relationship between the radiation dose received by the spleen and the hematological parameters of patients who underwent chemoradiotherapy after the diagnosis of locally advanced pancreatic cancer (LAPC).Materials and Methods: Patients with LAPC who were treated with chemoradiotherapy were retrospectively reviewed. Surgical status,chemoradiotherapy details, complete blood count values (baseline, mid-treatment, and end-of-treatment), mean spleen dose, and dose-volume parameters (V5, V10, V15, V20, V25, and V30) were recorded. The relationship between spleen dose-volume parameters and the development of grade 3 lymphopenia was evaluated by Spearman's rank correlation and receiver operating characteristic (ROC) analysis. Results: All dose parameters for the spleen were significantly correlated with the mid-treatment absolute lymphocyte count. In the ROC analysis, mean spleen dose (p=0.011; area under the curve [AUC]: 0.856; 95% confidence interval [CI]: 0.675-0.995), V15 (p=0.020; AUC: 0.938; 95% CI: 0.830-0.997), and V20 (p=0.002; AUC: 0.940; 95% CI: 0.811-0.1000) were significantly associated with mid-treatment grade ≥3 lymphopenia. Conclusion: A significant correlation was found between the dose received by the spleen during chemoradiotherapy in LAPC patients and the development of lymphopenia. Contouring the spleen as an organ at risk (OAR) and documenting doses is important to establish dose limitations.
Keywords: Pancreatic cancer, lymphope-nia, spleen radiation dose, acute toxicity.
Full-Text [PDF 810 kb]   (557 Downloads)    
Type of Study: Original Research | Subject: Radiation Biology
References
1. Ansari D, Tingstedt B, Andersson B, Holmquist F, Sturesson C,Williamsson C, et al. (2016) Pancreatic cancer: yesterday, todayand tomorrow. Future Oncol, 12(16): 1929-46. [DOI:10.2217/fon-2016-0010] [PMID]
2. Badiyan SN, Molitoris JK, Chuong MD, Regine WF, Kaiser A (2017) The role of radiation therapy for pancreatic cancer in the adjuvantand neoadjuvant settings. Surg Oncol Clin N Am, 26(3): 431-53. [DOI:10.1016/j.soc.2017.01.012] [PMID]
3. Pernar LIM and Tavakkoli A (2018) Anatomy and Physiology of theSpleen. Shackelford's Surgery of the Alimentary Tract, 136: 1591-1597. [DOI:10.1016/B978-0-323-40232-3.00136-9]
4. Kraal G and den Haan JMM (2016) The Spleen. In Encyclopedia ofImmunobiology. Ed: Ratcliffe MJH; 1st Edition, Ch 3; 407-412. [DOI:10.1016/B978-0-12-374279-7.07003-X]
5. Hey YY, Quah B, O'Neill HC (2017) Antigen-presenting capacity ofmurine splenic myeloid cells. BMC Immunol, 18(1): 4. [DOI:10.1186/s12865-016-0186-4] [PMID] []
6. Sunshine GH and Mitchell TJ (1985) Antigen presentation by spleendendritic cells. J Invest Dermatol, 85(1 Suppl): 110-114. [DOI:10.1111/1523-1747.ep12275577] [PMID]
7. Bronte V and Pittet MJ (2013) The spleen in local and systemicregulation of immunity. Immunity, 39(5): 806-818. [DOI:10.1016/j.immuni.2013.10.010] [PMID] []
8. Wolfe AR, Siedow M, Nalin A, DiCostanzo D, Miller ED, Diaz DA, etal. (2021) Increasing neutrophil-to-lymphocyte ratio followingradiation is a poor prognostic factor and directly correlates withsplenic radiation dose in pancreatic cancer. Radiother Oncol, 158: 207-214. [DOI:10.1016/j.radonc.2021.02.035] [PMID]
9. Liu J, Zhao Q, Deng W, Lu J, Xu X, Wang R, et al. (2017). Radiation-related lymphopenia is associated with spleen irradiation doseduring radiotherapy in patients with hepatocellular carcinoma. Radiat Oncol, 12(1): 90. [DOI:10.1186/s13014-017-0824-x] [PMID] []
10. Yalamanchali A, Zhang H, Huang KC, Mohan R, Lin SH, Zhu C, et al.(2020) Patient-specific lymphocyte loss kinetics as biomarker ofspleen dose in patients undergoing radiation therapy for upperabdominal malignancies. Adv Radiat Oncol, 6(1): 100545. [DOI:10.1016/j.adro.2020.08.002] [PMID] []
11. Alexandru M, Rodica A, Dragos-Eugen G, Mihai-Teodor G (2021) Assessing the spleen as an organ at risk in radiation therapy and itsrelationship with radiation-induced lymphopenia: A retrospectivestudy and literature review. Adv Radiat Oncol, 6(6): 100716. [DOI:10.1016/j.adro.2021.100761] [PMID] []
12. Saito T, Toya R, Yoshida N, Shono T, Matsuyama T, Ninomura S, et al. (2018) Spleen dose-volume parameters as a predictor of treat-ment-related lymphopenia during definitive chemoradiotherapyfor esophageal cancer. In Vivo, 32(6):1519-1525. [DOI:10.21873/invivo.11409] [PMID] []
13. Ng SP, Bahig H, Jethanandani A, Pollard C, Berends J, Sturgis EM, et al. (2020) Lymphopenia during radiotherapy in patients with oro-pharyngeal cancer. Radiother Oncol, 145: 95-100. [DOI:10.1016/j.radonc.2019.12.023] [PMID] []
14. Balmanoukian A, Ye X, Herman J, Laheru D, Grossman SA (2012) The association between treatment-related lymphopenia andsurvival in newly diagnosed patients with resected adenocarcino-ma of the pancreas. Cancer Invest, 30(8): 571-576. [DOI:10.3109/07357907.2012.700987] [PMID] []
15. Deng W, Xu C, Liu A, van Rossum PSN, Deng W, Liao Z, et al. (2019)The relationship of lymphocyte recovery and prognosis of esopha-geal cancer patients with severe radiation-induced lymphopeniaafter chemoradiation therapy. Radiother Oncol, 133: 9-15. [DOI:10.1016/j.radonc.2018.12.002] [PMID]
16. De B, Ludmir EB, Messick CA, Cagley MC, Morris VK, Das P, et al.(2021) Prognostic impact of lymphopenia and neutrophil-lymphocyte ratio for patients with anal squamous cell carcinoma. J Gastrointest Oncol, 12(5): 2412-2422. [DOI:10.21037/jgo-21-323] [PMID] []
17. Xie X, Gong S, Jin H, Yang P, Xu T, Cai Y, et al. (2020) Radiation-induced lymphopenia correlates with survival in nasopharyngealcarcinoma: impact of treatment modality and the baseline lym-phocyte count. Radiat Oncol, 15(1): 65. [DOI:10.1186/s13014-020-01494-7] [PMID] []
18. Lambin P, Lieverse RIY, Eckert F, Marcus D, Oberije C, van der WielAMA, et al. (2019) Lymphocyte-sparing radiotherapy: The rationalefor protecting lymphocyte-rich organs when combining radiothera-py with immunotherapy. Semin Radiat Oncol, 30(2): 187-193. [DOI:10.1016/j.semradonc.2019.12.003] [PMID] []
19. Arunagiri N, Kelly SM, Dunlea C, Dixon O, Cantwell J, Bhudia P, etal. (2021) The spleen as an organ at risk in pediatric radiotherapy:A SIOP-Europe Radiation Oncology Working Group report. Eur JCancer, 143: 1-10. [DOI:10.1016/j.ejca.2020.10.025] [PMID]
20. Chin AL, Aggarwal S, Pradhan P, et al. (2018) The role of bonemarrow and spleen irradiation in the development of acute hema-tologic toxicity during chemoradiation for esophageal cancer. AdvRadiat Oncol, 3(3): 297-304. [DOI:10.1016/j.adro.2018.02.005] [PMID] []
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Inan G, Aral I, Ozturk H, Gani Z, Arslan S, Tezcan Y. The effect of spleen dose-volume parameters on lymphopenia during chemoradiotherapy for pancreatic cancer. Int J Radiat Res 2023; 21 (3) :421-425
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Volume 21, Issue 3 (6-2023) Back to browse issues page
International Journal of Radiation Research
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