Tumor Biology

, Volume 37, Issue 1, pp 971–978 | Cite as

Radiation-related lymphopenia as a new prognostic factor in limited-stage small cell lung cancer

  • Oyeon Cho
  • Young-Taek Oh
  • Mison Chun
  • O Kyu Noh
  • Hyun-Woo Lee
Original Article


The purpose of this study was to investigate whether the minimum absolute lymphocyte count during radiotherapy (min ALC) and the absolute lymphocyte count 1 month after radiotherapy (post ALC) could predict clinical outcome in limited-stage small cell lung cancer (LS-SCLC) patients. We analyzed 73 LS-SCLC patients treated with chemotherapy and radiotherapy; we collected data on the min ALC from 62 patients and on the post ALC from 60 patients. Both min ALC and post ALC were statistically significant predictors of overall survival in multivariate analysis (hazard ratio [95 % confidence interval] 2.67 [1.06–6.75], P = 0.038 and 2.62 [1.19–5.74], P = 0.016, respectively). The median overall survival of the patients with min ALC ≤297 and >297 cells/μL was 12.2 and 35.3 months, respectively (P < 0.001). Patients with post ALC ≤698 and >698 cells/μL had an overall survival of 19.3 and 46.9 months, respectively (P = 0.001). The median overall survival of the lymphopenia (min ALC ≤ 297 cells/μL or post ALC ≤ 698 cells/μL) and the non-lymphopenia group (min ALC > 297 cells/μL and post ALC > 698 cells/μL) was 19.0 and 131.7 months, respectively, while the median progression survival was 8.1 and 16.6 months, respectively (P < 0.001 and P = 0.001). Radiation-related lymphopenia could predict poor survival in LS-SCLC. Its prognostic role should be evaluated in further prospective studies.


Limited-stage small cell lung cancer Lymphopenia Radiotherapy Survival 



Minimum absolute lymphocyte count during radiotherapy

Post ALC

The absolute lymphocyte count 1 month after radiotherapy


Radiation-related lymphopenia



The authors thank all staffs related to the treatment and all the patients suffering from small cell lung cancer.

Conflicts of interest


Supplementary material

13277_2015_3888_MOESM1_ESM.pdf (75 kb)
Online Resource 1 (a) The available gross tumor volumes and linear regression analysis of the 59 patients plotted against the min ALCs (b) Pearson correlation coefficients between gross tumor volume, total radiotherapy dose, and radiotherapy duration and the min ALCs or post ALCs (PDF 74 kb)
13277_2015_3888_MOESM2_ESM.pdf (480 kb)
Online Resource 2 The available white blood cell count and the relative tie lines for each of the 56 patients (a) and 6 patients (b) treated with concurrent or alternate CRT and sequential CRT plotted against the radiation days. The available absolute neutrophil counts and the relative tie lines for each of the 56 patients (c) and 6 patients (d) treated with concurrent or alternate CRT and sequential CRT plotted against the radiation days (PDF 480 kb)
13277_2015_3888_MOESM3_ESM.docx (14 kb)
Online Resource 3 (DOCX 14 kb)
13277_2015_3888_MOESM4_ESM.docx (14 kb)
Online Resource 4 (DOCX 14 kb)


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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Oyeon Cho
    • 1
  • Young-Taek Oh
    • 1
  • Mison Chun
    • 1
  • O Kyu Noh
    • 1
  • Hyun-Woo Lee
    • 2
  1. 1.Department of Radiation OncologyAjou University School of MedicineSuwonRepublic of Korea
  2. 2.Department of Hematology and Medical OncologyAjou University School of MedicineSuwonRepublic of Korea

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