title: Prognostic Value of Severe Lymphopenia During Pelvic Concurrent Chemoradiotherapy in Cervical Cancer.
abstract: OBJECTIVE
  To investigate whether common terminology criteria for adverse events (CTCAE) grade 4 lymphopenia (<200 cells/μl) during concurrent chemoradiotherapy (CCRT) is relevant to poor survival.
  
  
  METHODS
  We analyzed 124 patients with newly diagnosed Federation of Gynecology and Obstetrics (FIGO) stage I-III cervical cancer who received weekly cisplatin-based CCRT and brachytherapy using Kaplan-Meier curves and the Cox proportional hazard models.
  
  
  RESULTS
  Grade 4 lymphopenia significantly predicted disease-specific survival (DSS) and progression-free survival (PFS) (adjusted hazard ratio (95% confidence interval (CI))=3.6 (1.37-9.44), p=0.009 and 3.28 (1.27-8.48), p=0.014, respectively). The 5-year DSS and 3-year PFS were significantly higher among patients with grade 2-3 lymphopenia (≥200 cells/μl) than among those with grade 4 lymphopenia (84.8% vs. 50.4%, p<0.001, and 80.7% vs. 50%, p=0.002, respectively).
  
  
  CONCLUSIONS
  Severe lymphopenia during CCRT could predict poor survival.
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Oyeon
authors.initials: O
authors.lastname: Cho
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea chunm@ajou.ac.kr.
authors.forename: Mison
authors.initials: M
authors.lastname: Chun
authors.affiliation: Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Young-Taek
authors.initials: YT
authors.lastname: Oh
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: O Kyu
authors.initials: OK
authors.lastname: Noh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008231:Lymphopenia / Q000175:diagnosis / Q000401:mortality*; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*
chemical_list: D002945:Cisplatin
keywords: Cervical cancer; concurrent chemoradiotherapy; prognosis; severe lymphopenia