The prognostic value of circulating lymphocyte counts and ABO blood group in lung cancer stereotactic body radiation therapy: a retrospective study

Abstract

Background: Clinically, there is a lack of simple and feasible indicators to predict the efficacy of stereotactic body radiation therapy (SBRT). Circulating lymphocyte counts (CLCs) is considered to be related to curative effect in conventional radiotherapy of lung cancer, and blood groups are also associated with the survival. In this study, we investigate the prognostic value of CLCs and ABO blood groups in lung cancer patients treated with SBRT.Methods: We retrospectively analyzed 191 patients who were treated with lung cancer SBRT in Taizhou Hospital of Zhejiang Province from September 2014 to December 2018. The medical record system of Taizhou Hospital was used to collect relevant clinical data, such as stage, CLC, ABO blood groups and other important clinical co-variates. The effects of SBRT were evaluated by patient reexamination image data and telephone follow-up. The RECIST 1.1 standard was used to evaluate the short-term efficacy in the first, third, and sixth months after SBRT. Progression-free survival (PFS) was defined as the time from the day of SBRT to disease progression or death from any cause. Overall survival (OS) was measured from the day of SBRT until the last follow-up or death. Survival curves and univariate, multivariate logistic-regression analyses were used to expound the prognostic factors for local control (LC), PFS, and OS of lung cancer SBRT patients.Results: Univariate and multivariate analysis results showed that post-SBRT CLCs were independent factors for the short-term efficacy 3 and 6 months after lung cancer SBRT [hazard ratio (HR) =0.249, P=0.037; HR =0.347, P=0.012]. Survival analyses showed that the PFS and OS of lung cancer SBRT patients with A blood type was significantly shorter than that in the other three non-A blood groups (PFS: 6.5 vs. 10 months, HR =1.535, P=0.020; OS: 24 vs. 41 months, HR =1.578, P=0.048). Moreover, the patients with high post-SBRT CLCs in the non-A blood group had the longest PFS and OS after lung cancer SBRT (HR =0.551, P=0.043).Conclusions: Lung cancer SBRT patients with high-post-SBRT CLCs and non-A blood groups seem to exhibits best curative effect, which represent a potential opportunity to improve the clinical management of these patients. The mechanisms of this association deserve further verification and investigation.

Effect of Blood Type on Mortality Among Patients with Brain Metastases

“…Data on the association between blood type and mortality among patients with cancer are conflicting, with different studies reporting statistically significant associations between different blood types and mortality. [4][5][6][7][8][9][10] There were also studies that found no statistically significant association between blood type and mortality among patients with cancer. [11][12][13] The association between blood type and mortality may be related to the different degrees of immune response to the tumor across different blood types.…”

“…Brain metastases are the commonest type of malignant tumor to affect the central nervous system. [1][2][3] ABO blood type has been associated with mortality among patients with cancer, including but not limited to cancers of the lung, 4,5 bladder, 6 pancreas, 7,8 larynx, 9 and liver, 10 but the specific blood type that was associated with mortality was inconsistent. [4][5][6][7][8][9][10] There were also studies which found no statistically significant association between blood type and mortality among patients with cancer.…”

“…[11][12][13] Proposed mechanisms for the association between ABO blood type and mortality include the influence of ABO blood type on the body's inflammatory state and therefore the body's response to the tumor. 4,5 The association between ABO blood type and mortality among patients with brain metastases has thus far not been studied. Therefore, we aimed to investigate the association between ABO blood type and mortality in our cohort of patients who underwent surgical resection of brain metastases.…”

“…[1][2][3] ABO blood type has been associated with mortality among patients with cancer, including but not limited to cancers of the lung, 4,5 bladder, 6 pancreas, 7,8 larynx, 9 and liver, 10 but the specific blood type that was associated with mortality was inconsistent. [4][5][6][7][8][9][10] There were also studies which found no statistically significant association between blood type and mortality among patients with cancer. [11][12][13] Proposed mechanisms for the association between ABO blood type and mortality include the influence of ABO blood type on the body's inflammatory state and therefore the body's response to the tumor.…”

“…11-13 Proposed mechanisms for the association between ABO blood type and mortality include the influence of ABO blood type on the body’s inflammatory state and therefore the body’s response to the tumor. 4, 5…”