期刊
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
卷 36, 期 12, 页码 1747-1753出版社
WILEY
DOI: 10.1002/hed.23535
关键词
lymphopenia; head and neck squamous cell carcinoma; radiation; chemotherapy; treatment-related toxicities
资金
- NCI NIH HHS [P30 CA006973, T32 CA009071] Funding Source: Medline
- NIGMS NIH HHS [T32 GM066691] Funding Source: Medline
BackgroundSevere treatment-related lymphopenia occurs commonly in many cancers and is associated with early tumor progression. Data are lacking as to whether this occurs in squamous cell head and neck cancer. MethodsSerial total lymphocyte counts were retrospectively reviewed in patients with newly diagnosed squamous head and neck cancer undergoing chemoradiation and associated with treatment outcomes. ResultsThe median baseline total lymphocyte count in 56 patients was 1660 cells/mm(3), which fell by 73% to 445 cells/mm(3) 2 months after initiating chemoradiation (p < .0001). Human papillomavirus negative (HPV-) patients with a total lymphocyte count <500 cells/mm(3) at 2 months had significantly earlier disease progression than those with higher total lymphocyte counts (hazard ratio [HR], 5.75; p = .045). ConclusionBaseline total lymphocyte counts were normal, but at 2 months approximately 60% of patients had severe treatment-related lymphopenia regardless of HPV status. Severe treatment-related lymphopenia in HPV- patients is independently associated with earlier disease progression. Prospective studies are needed to confirm these findings, which suggest that immune preservation is important in this cancer. (c) 2014 Wiley Periodicals, Inc. Head Neck 36: 1747-1753, 2014
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