Lymphocytes and Neutrophil-to-Lymphocyte Ratio Variations After Selective Internal Radiation Treatment for HCC: A Retrospective Cohort Study.
Adult
Aged
Aged, 80 and over
Brachytherapy
/ methods
Carcinoma, Hepatocellular
/ immunology
Cohort Studies
Female
Humans
Liver Neoplasms
/ immunology
Lymphocyte Count
Lymphocytes
/ immunology
Male
Middle Aged
Neutrophils
/ immunology
Prognosis
Proportional Hazards Models
Retrospective Studies
Treatment Outcome
Anti-PD-1
Immune checkpoint inhibitors
Liver malignancies
Lymphopenia
Radioembolization
Yttrium-90
Journal
Cardiovascular and interventional radiology
ISSN: 1432-086X
Titre abrégé: Cardiovasc Intervent Radiol
Pays: United States
ID NLM: 8003538
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
04
02
2020
accepted:
26
03
2020
pubmed:
29
4
2020
medline:
20
1
2021
entrez:
29
4
2020
Statut:
ppublish
Résumé
Selective internal radiation therapy (SIRT) has been proposed for combination with immunotherapy to treat hepatocellular carcinoma (HCC). However, the toxicity of radiation toward lymphocytes is understudied after SIRT. The aim of this study was to describe variations of lymphocytes following SIRT and their potential prognostic impact. This is a retrospective cohort study of 164 patients treated with SIRT for HCC. Lymphocyte count and neutrophil-to-lymphocyte (NLR) ratio were evaluated at baseline and at 3 months. Primary endpoint was overall survival (OS). Median baseline lymphocyte count was 1.32 Giga/Liter (G/L) (standard deviation (SD) 0.64) at baseline versus 0.68 G/L (SD 0.41) at 3 months. The mean decrease of lymphocyte count was - 44% (standard deviation 0.24). At 3 months, only 21% of patients had normal (1 G/L or more) lymphocyte count, and 23% had lymphocyte count < 0.5 G/L. NLR at 3 months was significantly and independently associated with OS in multivariate Cox model. Median OS was 9.9 months (95% confidence interval (CI) 6.2-13.5) for patients with NLR at 3 months higher than 7.2 compared to 19.9 months in patients with an NLR lower that the 7.2 threshold (95% CI 16.3-23.3) (p = 0.003). The decrease in lymphocytes was frequent and deep after SIRT for HCC. NLR increase at 3 months was associated with poor survival.
Identifiants
pubmed: 32342156
doi: 10.1007/s00270-020-02467-9
pii: 10.1007/s00270-020-02467-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1175-1181Commentaires et corrections
Type : CommentIn
Références
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