PRETREATMENT LYMPHOCYTE COUNT AS PROGNOSTIC FACTOR IN PATIENTS WITH HEAD-AND-NECK CANCER

治療前淋巴球數量為頭頸癌患者的預後因子

吳燿宇(Yao-Yu Wu) ； 張東杰(Joseph Tung-Chieh Chang) ； 林倩伃(Chien-Yu Lin) ； 范綱行(Kang-Hsing Fan) ； 黃炳勝(Bing-Shen Huang) ； 洪宗民(Tsung-Min Hung) ； 謝承恩(Cheng-En Hsieh) ； 曾雁明(Ngan-Ming Tsang)

《放射治療與腫瘤學》 25卷1期 (2018/03) Pp. 1-12

https://doi.org/10.6316/TRO/201825(1)1

摘要

Purpose: The aim of this study was to investigate the relationship between the pretreatment lymphocyte count (preT LC) and clinical outcomes in patients with head-and-neck cancer treated with chemoradiation (CRT) or radiotherapy (RT) Materials and Methods: All 610 patients with newly diagnosed head-and-neck cancer who were treated by CCRT or RT were retrospectively reviewed. The median follow-up duration was 5.13 years. Overall survival (OS), local recurrence-free survival (LFS), regional recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) were analyzed by preT LC, with a cutoff of 1885 cells/μL. (＜ 1,885 cells/μL vs. ≥ 1,885 cells/μL) Results: The preT median lymphocyte count was 1,885 cells/μL (range: 285-5341). Patients in higher preT LC group was characterized by higher BMI (p = 0.023), more smoker (p ＜ 0.001), and more drinker (p = 0.043). On multivariate analysis, patients with higher preT LC were statistically significantly associated with better OS and DMFS than those with lower preT LC. There was no significant difference between preT LC groups in terms of LFS and RFS. Conclusions: Our data demonstrates that higher preT LC was independently associated with better DMFS and OS for patients with head-and-neck cancer treated with CRT or RT

關鍵字

Head-and-neck cancer ； Prognosis ； Lymphocyte count ； Radiotherapy

並列摘要

目的：本文主要探討治療前淋巴的數量是否會影響接受根治性放射治療的頭頸癌患者預後。材料與方法：本研究回溯收錄610位於林口長庚醫院接受過根治性放療之頭頸癌病患。整體追蹤的中位時間長度為5.13年。根據療程前淋巴球數量的多寡（＜ 1,885 cells/μL vs. ≥ 1,885 cells/μL）分群後，進行存活率、局部控制率、區域控制率及遠端轉移存活率的分析。結果：治療前的淋巴球數量的中位數為 1,885 cells/μL（範圍：285-5341）。相對於治療前有較少淋巴球的群體，較多淋巴球的族群有顯著較高的身體質量指數（BMI）、較高比率吸煙及喝酒者。在經過多變量分析後，治療前有較多淋巴球的群體比起較少的一方，在整體存活率及無遠端轉移存活率上有統計學上顯著較佳的表現。在局部及區域腫瘤控制率上，則無觀察到差異。結論：本研究觀察到在接受根治性放療的頭頸癌患者，治療前有較多淋巴球能有較佳的整體存活率及無遠端轉移存活率

並列關鍵字

頭頸癌 ； 預後 ； 淋巴球 ； 放射治療