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Lymphocytes and Neutrophil-to-Lymphocyte Ratio Variations After Selective Internal Radiation Treatment for HCC: A Retrospective Cohort Study

  • Clinical Investigation
  • Arterial Interventions
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Abstract

Purpose

Selective internal radiation therapy (SIRT) has been proposed for combination with immunotherapy to treat hepatocellular carcinoma (HCC). However, the toxicity of radiation toward lymphocytes is understudied after SIRT. The aim of this study was to describe variations of lymphocytes following SIRT and their potential prognostic impact.

Materials and Methods

This is a retrospective cohort study of 164 patients treated with SIRT for HCC. Lymphocyte count and neutrophil-to-lymphocyte (NLR) ratio were evaluated at baseline and at 3 months. Primary endpoint was overall survival (OS).

Results

Median baseline lymphocyte count was 1.32 Giga/Liter (G/L) (standard deviation (SD) 0.64) at baseline versus 0.68 G/L (SD 0.41) at 3 months. The mean decrease of lymphocyte count was − 44% (standard deviation 0.24). At 3 months, only 21% of patients had normal (1 G/L or more) lymphocyte count, and 23% had lymphocyte count < 0.5 G/L. NLR at 3 months was significantly and independently associated with OS in multivariate Cox model. Median OS was 9.9 months (95% confidence interval (CI) 6.2–13.5) for patients with NLR at 3 months higher than 7.2 compared to 19.9 months in patients with an NLR lower that the 7.2 threshold (95% CI 16.3–23.3) (p = 0.003).

Conclusions

The decrease in lymphocytes was frequent and deep after SIRT for HCC. NLR increase at 3 months was associated with poor survival.

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Authors and Affiliations

  1. Medical Oncology, Centre Eugène Marquis, Av bataille Flandres-dunkerque, 35042, Rennes, France

    Florian Estrade, Céline Lescure, Léa Muzellec, Maud Pedrono, Marc Pracht, Samuel Le Sourd & Julien Edeline

  2. Nuclear Medicine, Centre Eugène Marquis, Rennes, France

    Xavier Palard & Etienne Garin

  3. Interventional Radiology, Centre Eugène Marquis, Rennes, France

    Yan Rolland

  4. Hepatology, CHU Pontchaillou, Rennes, France

    Thomas Uguen

Authors
  1. Florian Estrade
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  2. Céline Lescure
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  3. Léa Muzellec
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  4. Maud Pedrono
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  5. Xavier Palard
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  6. Marc Pracht
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  7. Samuel Le Sourd
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  8. Yan Rolland
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  9. Thomas Uguen
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  10. Etienne Garin
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  11. Julien Edeline
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Corresponding author

Correspondence to Julien Edeline.

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Conflict of interest

YR, EG and JE served as consultants for BTG.

Ethical Approval

This retrospective study was accepted by our local ethic committee.

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As a retrospective study, informed consent was waived by the ethic committee.

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Estrade, F., Lescure, C., Muzellec, L. et al. Lymphocytes and Neutrophil-to-Lymphocyte Ratio Variations After Selective Internal Radiation Treatment for HCC: A Retrospective Cohort Study. Cardiovasc Intervent Radiol 43, 1175–1181 (2020). https://doi.org/10.1007/s00270-020-02467-9

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  • DOI: https://doi.org/10.1007/s00270-020-02467-9

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