The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis

Abstract Background The impact of radiation-related lymphocyte recovery on prognosis in locally advanced esophageal squamous cell carcinoma (LA-ESCC) remains unclear. Methods Patients with stage II-IVa ESCC who received definitive RT were screened. Collect absolute lymphocyte counts (ALCs) before, d...

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Main Authors: Hongshan Ji, Ping Zhang, Chanjun Zhen, Liyuan Fu, Dongjie Lv, Wenwen Bai, Rui Zhang, Jing Li, Hang Gao, Yajing Wang, Qiuying An, Yuhao Su, Hanyu Si, Xueying Qiao, Zhiguo Zhou
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Language:English
Published: BMC 2025-01-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02587-x
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author Hongshan Ji
Ping Zhang
Chanjun Zhen
Liyuan Fu
Dongjie Lv
Wenwen Bai
Rui Zhang
Jing Li
Hang Gao
Yajing Wang
Qiuying An
Yuhao Su
Hanyu Si
Xueying Qiao
Zhiguo Zhou
author_facet Hongshan Ji
Ping Zhang
Chanjun Zhen
Liyuan Fu
Dongjie Lv
Wenwen Bai
Rui Zhang
Jing Li
Hang Gao
Yajing Wang
Qiuying An
Yuhao Su
Hanyu Si
Xueying Qiao
Zhiguo Zhou
author_sort Hongshan Ji
collection DOAJ
description Abstract Background The impact of radiation-related lymphocyte recovery on prognosis in locally advanced esophageal squamous cell carcinoma (LA-ESCC) remains unclear. Methods Patients with stage II-IVa ESCC who received definitive RT were screened. Collect absolute lymphocyte counts (ALCs) before, during, and after RT. The recovery status of lymphocytes was observed at one-month post-RT (P1) and three months post-RT (P3). Patients with relatively lower lymphocyte recovery levels at P1 were divided into Group a and those with higher levels were divided into Group b. Patients with relatively lower lymphocyte recovery levels at P3 were divided into Group A and those higher were divided into Group B. Kaplan-Merier’s analysis and Cox analysis were conducted to compare survival outcomes. Binary logistic regression analyses was employed to ascertain factors associated with lymphocyte recovery. Results 116 patients were enrolled. During RT, ALCs reached the bottom 5 weeks after RT started and 70.7% of patients experienced G3 lymphopenia. The median OS for Group a and Group b were 38.1 months and 14.4 months, p = 0.097. The median PFS for Group a and Group b were 14.2 months and 10.0 months, p = 0.037. Whereas, the median OS for Group A and Group B was 14.5 months and 22.2 months, p = 0.019. The median PFS for Group A and Group B were 8.4 months and 12.4 months, p = 0.021. Cox multivariable analysis revealed that higher lymphocyte recovery level at P3 was significantly associated with superior OS (p = 0.040, HR0.636) and PFS (p = 0.028, HR0.627). The logistic analysis identified a positive association between G4 lymphopenia during RT (p = 0.012, OR 7.742) and PTV dose < 60 Gy (p = 0.014, OR 2.655) with lymphocyte recovery. Conclusions The prognostic value of lymphocyte recovery status at P3 appears to be greater than that of lymphocyte recovery status at P1 for locally advanced ESCC patients. Radiation-related lymphocyte recovery might serve as a valuable prognostic factor in LA-ESCC.
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spelling doaj-art-c1971ae99239412490a657559a9005742025-01-26T12:45:59ZengBMCRadiation Oncology1748-717X2025-01-012011810.1186/s13014-025-02587-xThe impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysisHongshan Ji0Ping Zhang1Chanjun Zhen2Liyuan Fu3Dongjie Lv4Wenwen Bai5Rui Zhang6Jing Li7Hang Gao8Yajing Wang9Qiuying An10Yuhao Su11Hanyu Si12Xueying Qiao13Zhiguo Zhou14Department of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityAbstract Background The impact of radiation-related lymphocyte recovery on prognosis in locally advanced esophageal squamous cell carcinoma (LA-ESCC) remains unclear. Methods Patients with stage II-IVa ESCC who received definitive RT were screened. Collect absolute lymphocyte counts (ALCs) before, during, and after RT. The recovery status of lymphocytes was observed at one-month post-RT (P1) and three months post-RT (P3). Patients with relatively lower lymphocyte recovery levels at P1 were divided into Group a and those with higher levels were divided into Group b. Patients with relatively lower lymphocyte recovery levels at P3 were divided into Group A and those higher were divided into Group B. Kaplan-Merier’s analysis and Cox analysis were conducted to compare survival outcomes. Binary logistic regression analyses was employed to ascertain factors associated with lymphocyte recovery. Results 116 patients were enrolled. During RT, ALCs reached the bottom 5 weeks after RT started and 70.7% of patients experienced G3 lymphopenia. The median OS for Group a and Group b were 38.1 months and 14.4 months, p = 0.097. The median PFS for Group a and Group b were 14.2 months and 10.0 months, p = 0.037. Whereas, the median OS for Group A and Group B was 14.5 months and 22.2 months, p = 0.019. The median PFS for Group A and Group B were 8.4 months and 12.4 months, p = 0.021. Cox multivariable analysis revealed that higher lymphocyte recovery level at P3 was significantly associated with superior OS (p = 0.040, HR0.636) and PFS (p = 0.028, HR0.627). The logistic analysis identified a positive association between G4 lymphopenia during RT (p = 0.012, OR 7.742) and PTV dose < 60 Gy (p = 0.014, OR 2.655) with lymphocyte recovery. Conclusions The prognostic value of lymphocyte recovery status at P3 appears to be greater than that of lymphocyte recovery status at P1 for locally advanced ESCC patients. Radiation-related lymphocyte recovery might serve as a valuable prognostic factor in LA-ESCC.https://doi.org/10.1186/s13014-025-02587-xEsophageal cancerRadiotherapyLymphocyte recoveryPrognosis
spellingShingle Hongshan Ji
Ping Zhang
Chanjun Zhen
Liyuan Fu
Dongjie Lv
Wenwen Bai
Rui Zhang
Jing Li
Hang Gao
Yajing Wang
Qiuying An
Yuhao Su
Hanyu Si
Xueying Qiao
Zhiguo Zhou
The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis
Radiation Oncology
Esophageal cancer
Radiotherapy
Lymphocyte recovery
Prognosis
title The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis
title_full The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis
title_fullStr The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis
title_full_unstemmed The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis
title_short The impact of radiation-related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients: a retrospective analysis
title_sort impact of radiation related lymphocyte recovery on the prognosis of locally advanced esophageal squamous cell carcinoma patients a retrospective analysis
topic Esophageal cancer
Radiotherapy
Lymphocyte recovery
Prognosis
url https://doi.org/10.1186/s13014-025-02587-x
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