Spleen Dose-Volume Parameters as a Predictor of Treatment-related Lymphopenia During Definitive Chemoradiotherapy for Esophageal Cancer

• Published in: In vivo (Athens) Vol. 32; no. 6; pp. 1519 - 1525
• Main Authors: Saito, Tetsuo, Toya, Ryo, Yoshida, Naoya, Shono, Takashi, Matsuyama, Tomohiko, Ninomura, Satoshi, Watakabe, Takahiro, Sasaki, Yutaka, Baba, Hideo, Oya, Natsuo
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.11.2018
• Subjects: Aged; Bone Marrow - pathology; Bone Marrow - radiation effects; Chemoradiotherapy - adverse effects; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - pathology; Esophageal Neoplasms - complications; Esophageal Neoplasms - epidemiology; Esophageal Neoplasms - pathology; Esophageal Neoplasms - radiotherapy; Female; Humans; Lymphocyte Count; Lymphopenia - epidemiology; Lymphopenia - etiology; Male; Middle Aged; Radiotherapy Dosage; Spleen - pathology; Spleen - radiation effects; dose–volume parameters; chemoradiotherapy; spleen; bone marrow; Treatment-related lymphopenia
• ISSN: 0258-851X; 1791-7549
• DOI: 10.21873/invivo.11409

Our study sought to identify dosimetric predictors of treatment-related lymphopenia during chemoradiotherapy for esophageal cancer. Patients with esophageal cancer who had received definitive chemoradiotherapy at our Institution were retrospectively assessed. The absolute volume of the spleen, body, and bone marrow that had received 5, 10, 20, and 30 Gy and the mean splenic dose were recorded. Multivariate linear regression analysis revealed that docetaxel use and spleen dose-volume parameters (V5, V10, V20, V30, and mean splenic dose) were significant independent factors negatively influencing the absolute lymphocyte count at nadir. An increase of 1 Gy in mean splenic dose predicted a 2.9% decrease in nadir absolute lymphocyte count. Univariable logistic regression analysis showed that the mean splenic dose was a significant predictor of grade 4 lymphopenia. None of the body or bone marrow dose-volume parameters significantly predicted lymphopenia. Higher spleen dose-volume parameters were associated with severe lymphopenia during chemoradiotherapy.