Ultrasonography combined with laboratory testing in evaluating the effect of radiotherapy modalities on lymphocyte subpopulations in lung cancer patients
Objective To explore the effect of different low-dose region of intensity-modulated radiation therapies(IMRT)on peripheral blood lymphocyte subpopulations in patients with primary lung cancer.Methods A total of 58 primary lung cancer patients who received radiotherapy(RT)in the Radiotherapy Department of the First Affiliated Hospital of Hebei North University from August 2020 to January 2021 were enrolled.They were assigned into IMRT group and volumetric-modulated arc radiotherapy(VMAT)group depending on the type of RT.RT planning parameters of two groups were recorded.The peripheral blood lymphocytes and their subpopulations,as well as ultrasound of supraclavicular and cervical lymph nodes examination were performed within 1 week before RT(T0),at the time point of RT dose reaching 40 Gy(T1)and 4 weeks after RT(T2).Results There were significant differences in Zone V5,V10,V15,V20,V25 and V30 in bilateral lungs before RT between IMRT group and VMAT group,which were significantly higher in VMAT group(P＜0.05).A significantly higher mean lung dose(MLD)was detected in IMRT group than that of VMAT group(P＜0.05).Before RT,no significant differences were detected in planning target volume(PTV)and lymphocyte subpopulations between groups(P＞0.05).After RT,significantly lower total count of lymphocytes,CD3+T count,CD3+CD4+T subpopulation and CD4+/CD8+were detected,but significantly higher CD3+CD8+T subpopulation and CD16+CD56+NK subpopulation were found in both groups(P＜0.01).Significantly lower CD3+CD4+T subpopulation and CD4+/CD8+were seen in VMAT group compared to IMRT group(P＜0.05).Logistic regression analysis revealed that the decline of total count of lymphocytes in primary lung cancer patients was significantly correlated with Zone V5 and V10 in bilateral lungs(P＜0.01),as well as Zone V15,V35,V40,V45,V50 and V60(P＜0.05).Ultrasound examination did not reveal significant differences in the size and morphology of supraclavicular and cervical lymph nodes,as well as the position of the lymphatic hilum between groups(P＞0.05).Conclusion Both IMRT and VMAT for primary lung cancer cause the reduction of peripheral blood lymphocytes and redistribution of lymphocyte subpopulations.VMAT offers a larger low-dose region in bilateral lungs and lower peripheral blood lymphocytes than those of IMRT.Ultrasonography merely influences the effect of different RT modalities on lymphocyte subpopulations in primary lung cancer patients.
NETL
NSTL
万方数据
