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Conference Paper: A Potential Survival Impact of Blood Immune Cells in Patients with Cervical Carcinoma Treated with Concurrent Chemoradiotherapy

TitleA Potential Survival Impact of Blood Immune Cells in Patients with Cervical Carcinoma Treated with Concurrent Chemoradiotherapy
Authors
Issue Date2019
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
Proceedings of the American Society for Radiation Oncology 61st Annual Meeting, Chicago, IL, USA, 15-18 September 2019. In International Journal of Radiation Oncology - Biology - Physics, 2019, v. 105 n. 1, Suppl., p. E343, abstract no. 2788 How to Cite?
AbstractPurpose/Objective(s): To exam the changes of circulating immune cells during chemoradiation and explore their impacts on survival in patients with cervical cancer. Materials/Methods: Study population included FIGO IB1-IVB cervical cancer patients treated with concurrent chemoradiotherapy from January 2015 to June 2018. All patients had 3D conformal pelvic radiotherapy plus concurrent cisplatin, followed by 3D-brachytherapy. All had baseline complete blood counts with differentials, then weekly during the course of treatment. The primary endpoint was progression-free survival (PFS). “Immune cells” of our interest included lymphocytes, neutrophil lymphocytes ratios, and platelets. Data are presented as mean (95% confident intervals) unless otherwise specified. Exploratory analysis on overall survival (OS) was also performed. Results: A total of 60 patients were eligible. The median follow-up was 21 months (range 7-40 months). All immune cells and hemoglobin decreased significantly during the course of chemoradiation; the rate of grade 3-4 lymphopenia, neutropenia, thrombocytopenia, and anemia during treatment were 96.7% 35.0%, 3.3% and 20.0%, respectively. The median time to nadir from the start of radiotherapy were 33.5 (14-49), 43 (21-66) and 39.5 (21-52) days for lymphocyte, neutrophil and platelet, respectively. Progression-free survival was 86.7% at 1 year and 72.7% at 2 years, and 1-year and 2-year OS was 94.8% and 80%, respectively. Patients with lymphocyte nadir below median had poorer PFS compared with those with lymphocyte nadir more than median(1-yr PFS 79.3% vs. 93.5%; 2-yr PFS 55.5% vs. 89.3%, P=0.024). Multivariate analysis showed that FIGO stage, the number of concurrent cisplatin cycles and lower lymphocyte nadir (HR 3.736, p=0.04) during treatment were significantly associated with PFS. Patients with CTCAE fast reduction of lymphocytes (grade 4 lymphopenia occurred before 3 weeks) showed a trend of poorer PFS than others(median PFS 15 months vs. not reached, P=0.199).The lymphocyte nadir was also significant for OS, with 1-yr OS 89.5% vs. 100%, 2-yr OS 69.8% vs. 89.9% for nadir below vs. above the median (P=0.024). Multivariate analysis for OS confirmed the significance of lymphocyte nadir (HR 7.54 for less than median vs above the median, p=0.015) after adjusting FIGO stage, chemotherapy cycles, hemoglobin before treatment and lymphocytes during treatment. Conclusion: Lymphopenia nadir during concurrent chemoradiotherapy is significantly associated with PFS and OS in patients with cervical cancer. Greater or quicker reduction of lymphocytes during chemoradiotherapy predicts poorer survival. Validation studies with larger sample sizes are needed.
DescriptionPoster Viewing Q&A Session - no. 2788
Persistent Identifierhttp://hdl.handle.net/10722/294038
ISSN
2019 Impact Factor: 5.859
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYang, L-
dc.contributor.authorXu, ZY-
dc.contributor.authorChang, AT-
dc.contributor.authorWang, Q-
dc.contributor.authorChen, X-
dc.contributor.authorShen, L-
dc.contributor.authorHui, SK-
dc.contributor.authorLee, KW-
dc.contributor.authorChan, W-
dc.contributor.authorZhou, Y-
dc.contributor.authorChen, F-
dc.contributor.authorZha, J-
dc.contributor.authorJin, JY-
dc.contributor.authorKong, FP-
dc.date.accessioned2020-11-23T08:25:27Z-
dc.date.available2020-11-23T08:25:27Z-
dc.date.issued2019-
dc.identifier.citationProceedings of the American Society for Radiation Oncology 61st Annual Meeting, Chicago, IL, USA, 15-18 September 2019. In International Journal of Radiation Oncology - Biology - Physics, 2019, v. 105 n. 1, Suppl., p. E343, abstract no. 2788-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/294038-
dc.descriptionPoster Viewing Q&A Session - no. 2788-
dc.description.abstractPurpose/Objective(s): To exam the changes of circulating immune cells during chemoradiation and explore their impacts on survival in patients with cervical cancer. Materials/Methods: Study population included FIGO IB1-IVB cervical cancer patients treated with concurrent chemoradiotherapy from January 2015 to June 2018. All patients had 3D conformal pelvic radiotherapy plus concurrent cisplatin, followed by 3D-brachytherapy. All had baseline complete blood counts with differentials, then weekly during the course of treatment. The primary endpoint was progression-free survival (PFS). “Immune cells” of our interest included lymphocytes, neutrophil lymphocytes ratios, and platelets. Data are presented as mean (95% confident intervals) unless otherwise specified. Exploratory analysis on overall survival (OS) was also performed. Results: A total of 60 patients were eligible. The median follow-up was 21 months (range 7-40 months). All immune cells and hemoglobin decreased significantly during the course of chemoradiation; the rate of grade 3-4 lymphopenia, neutropenia, thrombocytopenia, and anemia during treatment were 96.7% 35.0%, 3.3% and 20.0%, respectively. The median time to nadir from the start of radiotherapy were 33.5 (14-49), 43 (21-66) and 39.5 (21-52) days for lymphocyte, neutrophil and platelet, respectively. Progression-free survival was 86.7% at 1 year and 72.7% at 2 years, and 1-year and 2-year OS was 94.8% and 80%, respectively. Patients with lymphocyte nadir below median had poorer PFS compared with those with lymphocyte nadir more than median(1-yr PFS 79.3% vs. 93.5%; 2-yr PFS 55.5% vs. 89.3%, P=0.024). Multivariate analysis showed that FIGO stage, the number of concurrent cisplatin cycles and lower lymphocyte nadir (HR 3.736, p=0.04) during treatment were significantly associated with PFS. Patients with CTCAE fast reduction of lymphocytes (grade 4 lymphopenia occurred before 3 weeks) showed a trend of poorer PFS than others(median PFS 15 months vs. not reached, P=0.199).The lymphocyte nadir was also significant for OS, with 1-yr OS 89.5% vs. 100%, 2-yr OS 69.8% vs. 89.9% for nadir below vs. above the median (P=0.024). Multivariate analysis for OS confirmed the significance of lymphocyte nadir (HR 7.54 for less than median vs above the median, p=0.015) after adjusting FIGO stage, chemotherapy cycles, hemoglobin before treatment and lymphocytes during treatment. Conclusion: Lymphopenia nadir during concurrent chemoradiotherapy is significantly associated with PFS and OS in patients with cervical cancer. Greater or quicker reduction of lymphocytes during chemoradiotherapy predicts poorer survival. Validation studies with larger sample sizes are needed.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physics-
dc.relation.ispartofThe American Society for Radiation Oncology 61st Annual Meeting-
dc.titleA Potential Survival Impact of Blood Immune Cells in Patients with Cervical Carcinoma Treated with Concurrent Chemoradiotherapy-
dc.typeConference_Paper-
dc.identifier.emailKong, FP: kong0001@hku.hk-
dc.identifier.authorityKong, FP=rp02508-
dc.description.natureabstract-
dc.identifier.doi10.1016/j.ijrobp.2019.06.1755-
dc.identifier.hkuros319988-
dc.identifier.volume105-
dc.identifier.issue1, Suppl.-
dc.identifier.spageE343, abstract no. 2788-
dc.identifier.epageE343, abstract no. 2788-
dc.identifier.isiWOS:000485671501075-
dc.publisher.placeUnited States-
dc.identifier.issnl0360-3016-

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