2023 World Conference on Lung Cancer (Posters)-EP08.02. Higher Radiation Dose to Immune Cells is a Negative Prognostic Factor in Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC)

EP08.02. Higher Radiation Dose to Immune Cells is a Negative Prognostic Factor in Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC) - PDF(Slides)

Back to course

Pdf Summary

A study conducted at the University of Pennsylvania investigated the relationship between the effective radiation dose to immune cells (EDIC) and the outcomes of patients with locally advanced non-small cell lung cancer (NSCLC). The researchers hypothesized that higher EDIC would be associated with increased treatment-related lymphopenia (TRL) and inferior cancer control.<br /><br />The retrospective study included 786 patients with unresectable locally advanced NSCLC who were treated with chemoradiotherapy (CRT) with or without consolidative immunotherapy. EDIC was calculated based on mean heart dose, mean lung dose, integral total dose volume, and number of radiation therapy fractions. Complete blood count and absolute lymphocyte counts were collected at the start and end of radiation treatment.<br /><br />The results showed that higher EDIC was associated with poor cancer outcomes, severe lymphopenia, and acute treatment toxicities. Proton therapy was identified as a potential tool to reduce EDIC. The median EDIC was 4.7Gy overall and 4.3Gy in the immunotherapy group. The median follow-up period was 64.2 months, with a median progression-free survival of 11.1 months and a median overall survival of 28.8 months.<br /><br />Further analysis using Cox regression models identified several predictors of overall survival, including age, smoking status, performance status, histology, tumor stage, chemotherapy regimen, and EDIC. Logistic regression models showed that higher EDIC, along with other factors such as performance status and lymphocyte count at baseline, was associated with the development of grade 4 lymphopenia.<br /><br />In conclusion, the study found that higher EDIC was predictive of severe lymphopenia, inferior cancer outcomes, and treatment toxicities in patients with locally advanced NSCLC. The findings suggest that reducing EDIC, potentially through the use of proton therapy, could improve patient outcomes.

Asset Subtitle

Nikhil Yegya-Raman

Meta Tag

Speaker Nikhil Yegya-Raman

Topic Local-Regional NSCLC: Multimodality Therapy

Keywords

University of Pennsylvania

radiation dose

immune cells

non-small cell lung cancer

chemoradiotherapy

consolidative immunotherapy

lymphopenia

cancer control

proton therapy

overall survival