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Clinical Considerations of Splenic Dose Constraints to Mitigate Radiation-Induced Lymphopenia.

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Cancer medicine 📖 저널 OA 96.3% 2022: 15/15 OA 2023: 14/14 OA 2024: 36/36 OA 2025: 164/164 OA 2026: 215/232 OA 2022~2026 2026 Vol.15(1) p. e71553
Retraction 확인
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PICO 자동 추출 (휴리스틱, conf 2/4)

유사 논문
P · Population 대상 환자/모집단
159 patients were enrolled.
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
It is important not only to prevent severe lymphopenia during RT but also to focus on improving lymphocyte recovery after RT. Constraining the spleen V is a key approach.

Ma Y, Zhang S, Ma J, Gao A, Liu J, Ma H, Zhou Q, Qian J, Zhang L

📝 환자 설명용 한 줄

[BACKGROUND] The spleen dose-volume threshold for lymphopenia in abdominal radiotherapy has not yet reached a consensus.

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↓ .bib ↓ .ris
APA Ma Y, Zhang S, et al. (2026). Clinical Considerations of Splenic Dose Constraints to Mitigate Radiation-Induced Lymphopenia.. Cancer medicine, 15(1), e71553. https://doi.org/10.1002/cam4.71553
MLA Ma Y, et al.. "Clinical Considerations of Splenic Dose Constraints to Mitigate Radiation-Induced Lymphopenia.." Cancer medicine, vol. 15, no. 1, 2026, pp. e71553.
PMID 41568450 ↗
DOI 10.1002/cam4.71553

Abstract

[BACKGROUND] The spleen dose-volume threshold for lymphopenia in abdominal radiotherapy has not yet reached a consensus. Our previous research indicated a correlation between these factors, but the threshold has not been determined. Therefore, we investigated the dynamic changes in lymphocytes during radiotherapy (RT), identified the spleen dose threshold, and examined how these factors affect patient prognosis.

[METHODS] The absolute lymphocyte counts (ALC) of gastric cancer patients were collected before, during, and after RT. Lymphocyte recovery status was assessed using the lymphocyte recovery index (LRI). LRI cut off was considered as insufficient recovery. Splenic dosimetric parameters were collected, and their impact on predicting grade 4 (G4) lymphopenia was evaluated using logistic regression analysis. Cox regression analysis was used to evaluate the relationship between lymphocyte depletion and recovery status and prognosis.

[RESULTS] 159 patients were enrolled. The median ALC dropped by 85.71% after RT. The occurrence of G4 and G1-3 lymphopenia was observed in 30.2% and 69.8% of cases, respectively. There were 12.6% of patients whose ALC had recovered at 120 days after RT, while the remaining 87.4% were still accompanied by lymphopenia. Cox multivariable analysis showed that pTNM stage and LRI were independent prognostic factors affecting overall survival, and the independent prognostic factors for disease-free survival were pTNM stage and change in ALC. Splenic D and V were related to G4 lymphopenia and eventually V affected prognosis. Constraining the spleen V to < 180.6 cm and < 272.2 cm may reduce the incidence of G4 lymphopenia and further decrease the risk of death by 60.9%.

[CONCLUSIONS] Patients with severe lymphocyte decline during RT and insufficient lymphocyte recovery afterward have a worse prognosis. It is important not only to prevent severe lymphopenia during RT but also to focus on improving lymphocyte recovery after RT. Constraining the spleen V is a key approach.

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