Lymphocyte subset distribution after radiation therapy for cancer of the uterine cervix. Possible prognostic implications and correlation with disease course

Pillai, Radhakrishna; Balaram, Prabha; Nair, Bindu S.; Hareendran, N.K.; Padmanabhan, T. K.; Mk, Nair

doi:10.1002/1097-0142(19910415)67:8<2071::aid-cncr2820670811>3.0.co;2-i

Cited by 19 publications

(5 citation statements)

References 20 publications

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“…Long-standing lymphophenia has indeed been found after radiotherapy for cancer of the breast (39). Similar reductions of lymphocyte populations have, however, been found after radiotherapy for carcinoma of the cervix (40). Since the CRC trial was randomised this study should offer the best possibilities to explore differences between the groups.…”

Section: Radiation -Induced Cancercontrasting

confidence: 78%

Late Effects of Radiotherapy in the Treatment of Breast Cancer

Wallgren¹

1992

Acta Oncologica

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Section: Radiation -Induced Cancercontrasting

confidence: 78%

Late Effects of Radiotherapy in the Treatment of Breast Cancer

Wallgren¹

1992

Acta Oncologica

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“…T lymphocyte subsets were shown to be further disturbed following external radiotherapy [24,25]. In the RIT group in our series, both the percentage and the absolute number of CD4+ and CD8+ T lymphocytes and the CD4+ to CD8+ ratio were significantly different from those in the control group prior to treatment ( Table 2).…”

Section: Discussionsupporting

confidence: 92%

Comparison between radioimmunotherapy and external beam radiation therapy for patients with hepatocellular carcinoma

Zeng

Tang

Yang

et al. 2002

European Journal of Nuclear Medicine and Molecular Imaging

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It has previously been observed in animal studies that, at equivalent doses, radioimmunotherapy (RIT) is 2.5 times more effective than multiple fractions of external beam radiation therapy (EBRT) in inhibiting tumour growth. In this study, we compared the use of RIT and EBRT in patients with hepatocellular carcinoma (HCC), treated during the past 10 years. Of 67 patients without extrahepatic involvement, 32 were treated with hepatic artery ligation combined with RIT (the RIT group) while 35 were treated with a combination of hepatic arterial chemo-embolisation and EBRT (the EBRT group). The patients in the RIT group received (131)I-Hepama-1 monoclonal antibody, which was infused through the hepatic artery catheter. The patients in the EBRT group received transcatheter arterial chemo-embolisation and limited-field EBRT using a linear accelerator. Parameters observed include tumour response, alpha-fetoprotein (AFP) level in serum, human anti-murine antibody (HAMA) assay, T lymphocyte subsets, survival rates, routine parameters, sequential resection rates and histopathological status of the resection specimens. The sequential resection rates were 53% (17/32) and 23% (8/35), and tumour response rates were 72% (23/32) and 86% (30/35) in the RIT and EBRT groups, respectively. The main side-effects in the RIT group were mild allergic reactions. The most common toxicity in the EBRT group was an increase in liver enzymes. The liver tissue in the target volume was injured by EBRT. The injured liver tissue revealed a low-attenuation area adjacent to the hepatic tumour within the target volume on follow-up computed tomography studies after EBRT. On pathological evaluation, the low-attenuation area revealed hyperaemia, distended hepatic sinusoids packed with erythrocytes and hepatic cell loss. The sequential resection specimens from both the RIT and the EBRT group showed residual cancer tissue located at the edge of the mass. The residual cancer cells presented as giant cells under microscopy. T lymphocyte subsets observed prior to treatment did not significantly change after RIT, but were significantly disturbed by EBRT. HAMA formation was the major reason for discontinuing RIT, the incidence being as high as 34% (11/32). Intrahepatic and pulmonary metastases occurred more frequently in the EBRT group (63%) than in the RIT group (22%). The 1-, 2-, 3- and 4-year survival rates were 50%, 41%, 34% and 31% in the RIT group, and 77%, 39%, 11% and 7% in the EBRT group, respectively. It is interesting that the serum AFP level showed a transient increase, the mechanism and importance of which are not known, but are discussed. Both RIT and EBRT are useful treatment modalities for unresectable HCC, serving to prolong survival. However, RIT is much less toxic than EBRT, the side-effects of which include radiation injury to the liver and disturbance of T lymphocyte subsets.

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“…This was not invariably the case however, and new patients presented with low CD4 counts prior to any treatment. On the other hand, subset counts fell rapidly following the commencement of therapy and took a long time to recover, as observed in previous studies (15)(16)(17). It is difficult to compare these results with radiotherapy and chemotherapy given for other pelvic cancers since protocols vary considerably for different diseases.…”

Section: Discussionmentioning

confidence: 50%

Immunocompetent for immunotherapy? A study of the immunocompetence of cervical cancer patients

Fiander

Adams²,

Evans³

et al. 1995

Int J Gynecol Cancer

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Sixty-five patients with cervical carcinoma and 17 control subjects were studied to determine immunocompetence as a prerequisite for immunotherapy using live virus vectors. T-cell immunity, measured by surface phenotype and proliferative assays, was reduced with increasing volume of invasive disease, and independent of treatment effects. Both the CD4+ and CD8+ subsets were affected so that the CD4:8 ratio remained within normal limits. In contrast B-cell number, immunoglobulins and complement were normal as were in vivo responses to a polysaccharide vaccine. Thus, determination of immunocompetence prior to use of live vector immunotherapy requires assessment of each individual subject, especially in those with advanced disease.

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Lymphocyte subset distribution after radiation therapy for cancer of the uterine cervix. Possible prognostic implications and correlation with disease course

Cited by 19 publications

References 20 publications

Late Effects of Radiotherapy in the Treatment of Breast Cancer

Late Effects of Radiotherapy in the Treatment of Breast Cancer

Comparison between radioimmunotherapy and external beam radiation therapy for patients with hepatocellular carcinoma

Immunocompetent for immunotherapy? A study of the immunocompetence of cervical cancer patients

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