Abstract
BackgroundStudies increasingly focus on the impact of radiotherapy on immunity; however, the role of peripheral cellular immunity prior to radiotherapy in cancer patients remains largely unknown. In this study, we investigated the predictive roles of lymphocyte subsets on tumor progression in non-small cell lung cancer (NSCLC) patients undergoing radiotherapy, and their expression in NSCLC patients at first relapse.MethodsWe enrolled 70 NSCLC patients and 14 age- and sex-matched healthy donors and tested the lymphocyte subsets in their peripheral blood by flow cytometry. Among them, 40 newly diagnosed patients received radiotherapy and were enrolled to investigate the predictive value of lymphocyte subsets on tumor progression after radiotherapy by uni- and multivariate analyses; 30 patients at first relapse were included to evaluate the differences of lymphocyte subsets between them and first diagnosed patients and healthy volunteers.ResultsIncreased proportions of regulatory T cells, CD8+ T cells, and CD8+CD28- T cells and decreased CD4+ T cells and CD4/CD8 ratios were observed in NSCLC patients at first relapse compared to newly diagnosed patients. In the 40 first diagnosed patients undergoing radiotherapy, uni- and multivariate analyses showed that increased level of regulatory T cells correlated with poor progression-free survival (hazard ratio = 2.55 and 3.76, P = 0.022 and 0.010, respectively).ConclusionsPeripheral regulatory T cells were increased and independently predict tumor progression in NSCLC patients undergoing radiotherapy, suggesting the promising combination of radiotherapy and immunotherapy.
Highlights
As the most common malignant tumor worldwide, approximately 80% of lung cancer patients are nonsmall cell lung cancer (NSCLC) cases [1, 2]
The present study aimed to evaluate the predictive value of regulatory T cells (Treg) cells and other lymphocyte subsets in non-small cell lung cancer (NSCLC) patients treated with radiotherapy, and their expression in NSCLC patients at first relapse
No differences of baseline characteristics were observed between patients at first diagnosis and relapse, providing an opportunity to compare the expression of lymphocyte subsets between them
Summary
As the most common malignant tumor worldwide, approximately 80% of lung cancer patients are nonsmall cell lung cancer (NSCLC) cases [1, 2]. Radiotherapy lonely and in combination with other therapies are used as prevailing treatments in ~ 60% of newly diagnosed NSCLC patients [3]. According to the immune mechanism of radiotherapy, we proposed that the immune status before radiotherapy may impact the tumor response to radiation and affect long-term survival. We aimed to evaluate the clinical values of pretreatment immune cells in peripheral blood in NSCLC patients undergoing radiation therapy. Studies increasingly focus on the impact of radiotherapy on immunity; the role of peripheral cellular immunity prior to radiotherapy in cancer patients remains largely unknown. We investigated the predictive roles of lymphocyte subsets on tumor progression in non-small cell lung cancer (NSCLC) patients undergoing radiotherapy, and their expression in NSCLC patients at first relapse
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