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Abstract
PurposeThe influence of radiotherapy on patient immune cell subsets has been established by several groups. Following a previously published analysis of immune changes during and after curative radiotherapy for prostate cancer, this analysis focused on describing correlations of changes of immune cell subsets with radiation treatment parameters.Patients and methodsFor 13 patients treated in a prospective trial with radiotherapy to the prostate region (primary analysis) and five patients treated with radiotherapy to prostate and pelvic nodal regions (exploratory analysis), already published immune monitoring data were correlated with clinical data as well as radiation planning parameters such as clinical target volume (CTV) and volumes receiving 20 Gy (V20) for newly contoured volumes of pelvic blood vessels and bone marrow.ResultsMost significant changes among immune cell subsets were observed at the end of radiotherapy. In contrast, correlations of age and CD8+ subsets (effector and memory cells) were observed early during and 3 months after radiotherapy. Ratios of T cells and T cell proliferation compared to baseline correlated with CTV. Early changes in regulatory T cells (Treg cells) and CD8+ effector T cells correlated with V20 of blood vessels and bone volumes.ConclusionsPatient age as well as radiotherapy planning parameters correlated with immune changes during radiotherapy. Larger irradiated volumes seem to correlate with early suppression of anti-cancer immunity. For immune cell analysis during normofractionated radiotherapy and correlations with treatment planning parameters, different time points should be looked at in future projects.Trial registration number:NCT01376674, 20.06.2011
Highlights
Radiotherapy, mostly in combination with androgen deprivation therapy (ADT), is one of the curative options for localized prostate adenocarcinoma
volumes receiving 20 Gy (V20) values were used for contoured blood vessels as well as total pelvic bone marrow (PBM)
We demonstrated previously that peripheral immune cell subsets are affected during and after curative, normofractionated radiotherapy for intermediate to high-risk prostate cancer [21]
Summary
Radiotherapy, mostly in combination with androgen deprivation therapy (ADT), is one of the curative options for localized prostate adenocarcinoma. With imageguidance and conformal radiotherapy planning, higher radiation doses have become achievable without excessive toxicity [2]. Combining immunotherapy with radiotherapy has become a major field of investigation [8,9,10]. There are a lot of uncertainties about the specifics of radiotherapy (dose, fractionation, timing) to be best combined with immunotherapy. Sequencing of different therapy modalities, as well as fractionation and dosing of radiotherapy, seems to play a major role for synergistic effects [11]. Fractionation and total doses will probably vary for the immunotherapy modality applied [15, 16]
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