Cellular immune defect caused by postsurgical radiation therapy in patients with head and neck cancer.
The effects of locoregional postoperative radiation therapy (60 Gy on average) on cellular immunity were investigated in 11 patients with squamocellular carcinomas of the oral cavity, pharynx, or larynx. During radiation treatment, the total lymphocyte counts, CD8+ T-lymphocyte count, and especially CD4+ T-lymphocyte count decreased significantly. The mean CD4+ T-lymphocyte counts dropped from an average of 739/microl to 183/microl (p <0.001), and the CD4+/CD8+ quotient also decreased significantly. Not only the lymphocyte counts but also the in vitro lymphocyte stimulation responses to several mitogens decreased, with reductions averaging 10% to 50% of normal responses by the end of radiation therapy. Within 3 to 4 weeks after radiation therapy, the CD4+ T-lymphocyte counts and the in vitro lymphocyte stimulation responses showed a tendency toward normalization. This study shows that postoperative locoregional radiation therapy in patients with head and neck cancer induces a severe generalized impairment of cellular immunity.
Department of Otorhinolaryngology-Head and Neck Surgery, Armed Forces Hospital, Ulm, Germany.
M
M
Tisch
F
F
Heimlich
V
V
Daniel
G
G
Opelz
H
H
Maier
D018791:CD4 Lymphocyte Count / Q000528:radiation effects; D016516:CD4-CD8 Ratio / Q000528:radiation effects; D015496:CD4-Positive T-Lymphocytes / Q000528:radiation effects; D018414:CD8-Positive T-Lymphocytes / Q000528:radiation effects; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D008213:Lymphocyte Activation / Q000528:radiation effects; D018655:Lymphocyte Count / Q000528:radiation effects; D008934:Mitogens; D009062:Mouth Neoplasms / Q000532:radiotherapy / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D015375:Receptors, Interleukin-2 / Q000097:blood; D019947:Receptors, Interleukin-6 / Q000097:blood; D013601:T-Lymphocytes / Q000528:radiation effects*
D007376:Interleukin-2; D015850:Interleukin-6; D008934:Mitogens; D015375:Receptors, Interleukin-2; D019947:Receptors, Interleukin-6; D007371:Interferon-gamma