Blood Lymphocytes as a Prognostic Factor for Stage III Non-small Cell Lung Cancer with Concurrent Chemoradiation

Yong-Hyub Kim; Yoo-Duk Choi; Sung-Ja Ahn; Young-Chul Kim; In-Jae Oh; Cheol-Kyu Park; Taek-keun Nam; Mee Sun Yoon; Jae-Uk Jeong; Ick Joon Cho; Ju-Young Song; Shinhaeng Cho

doi:10.20944/preprints202310.0739.v1

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preprints.org > medicine and pharmacology > oncology and oncogenics > doi: 10.20944/preprints202310.0739.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Blood Lymphocytes as a Prognostic Factor for Stage III Non-small Cell Lung Cancer with Concurrent Chemoradiation

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Version 1 : Received: 10 October 2023 / Approved: 10 October 2023 / Online: 11 October 2023 (12:52:09 CEST)

A peer-reviewed article of this Preprint also exists.

Kim, Y.-H.; Choi, Y.-D.; Ahn, S.-J.; Kim, Y.-C.; Oh, I.-J.; Nam, T.-K.; Jeong, J.-U.; Song, J.-Y. Blood Lymphocytes as a Prognostic Factor for Stage III Non-Small Cell Lung Cancer with Concurrent Chemoradiation. Chonnam Medical Journal 2024, 60, 40, doi:10.4068/cmj.2024.60.1.40. Kim, Y.-H.; Choi, Y.-D.; Ahn, S.-J.; Kim, Y.-C.; Oh, I.-J.; Nam, T.-K.; Jeong, J.-U.; Song, J.-Y. Blood Lymphocytes as a Prognostic Factor for Stage III Non-Small Cell Lung Cancer with Concurrent Chemoradiation. Chonnam Medical Journal 2024, 60, 40, doi:10.4068/cmj.2024.60.1.40.

Abstract

In this study, we aimed to identify blood lymphocytes as a prognostic factor for survival in patients with locally advanced stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (CCRT). We conducted a secondary analysis of 196 patients enrolled in the Korean Radiation Oncology Group 0903 phase III clinical trial to evaluate the prognostic significance of circulating blood lymphocyte levels. The median total lymphocyte count (TLC) reduction ratio during CCRT was 0.74 (range: 0.29 – 0.97). In multivariate analysis, patient age (p = 0.014) and gross tumor volume (GTV, p = 0.031) were significant factors associated with overall survival, while TLC reduction (p = 0.018) and pretreatment neutrophil-to-lymphocyte ratio (NLR; p = 0.010) were associated with progression-free survival (PFS). In multivariate logistic regression analysis, pretreatment NLR, GTV, and heart V20 were significantly associated with TLC reduction. TLC reduction during CCRT is a significant prognostic factor for PFS, and heart V20 is significantly associated with TLC reduction. Thus, constraining the volume of the radiation dose to the whole heart must be prioritized to reduce TLC.

Keywords

Blood lymphocytes; CCRT; non-small cell lung cancer

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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