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淋巴缺血是直肠腺癌患者接受长期化疗或放射治疗的不良预后因素

Ioannis M Koukourakis¹, Ioannis Georgakopoulos¹, Dimitra Desse¹

¹Radiation Oncology Unit, 1st Department of Radiology, Medical School, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Radiation oncology journal

|January 3, 2025

概括

对直肠腺癌的化学放射治疗 (CRT) 显著降低了淋巴细胞数量,导致淋巴衰竭. 这种淋巴缺血与较差的瘤回归和较高的远程转移风险有关,这凸显了在治疗期间需要保护免疫系统的需要.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
辐射疗法辐射疗法

背景情况:

新辅助化学放射治疗 (CRT) 是局部晚期直肠腺癌的标准.
新出现的数据表明免疫疗法在不匹配修复缺陷直肠癌中的有效性,突出显示了免疫系统的作用.
放射治疗 (RT) 可以刺激抗瘤免疫力,但也会导致淋巴缺血,可能阻碍免疫反应.

研究的目的:

在直肠腺癌患者中研究CRT对外围血液淋巴细胞计数 (LC) 的影响.
确定CRT诱导的淋巴缺血对瘤反应和患者预后的影响.

主要方法:

对33名用CRT治疗的直肠腺癌患者的回顾性分析.
在CRT前后监测周围血液淋巴细胞计数.
在LC,瘤回归和生存结果之间的相关性分析.

主要成果:

在CRT后观察到LC的显著下降 (2,184/μL到517/μL,p<0.001).
较差的瘤回归与较低的CRT后LC相关 (p = 0.036).
淋巴缺血与远程无转移生存率较差相关 (p = 0.003),低LC患者中有44.5%患有远程转移,高LC患者为0%.

结论:

淋巴缺血是接受新辅助CRT的直肠腺癌患者的显著不良事件.
由CRT诱导的淋巴衰竭对瘤反应和预后有影响.
在CRT期间保护免疫系统是未来临床研究的关键领域.

关键词:

腺癌是什么?腺癌是什么?腺癌是什么?淋巴细胞减少症 (Lymphopenia) 是一种预测预后预测预测辐射疗法辐射疗法这是直肠瘤.

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