Head and Neck Cancer

PV QA 2 - Poster Viewing Q&A 2

MO_30_2723 - Lymphopenia During Radiation Therapy In Patients With Oropharyngeal Cancer: Does It Affect Survival Outcomes?

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Lymphopenia During Radiation Therapy In Patients With Oropharyngeal Cancer: Does It Affect Survival Outcomes?
S. P. Ng1, H. Bahig1, A. Jethanandani1, C. Pollard III1, J. Berends2, E. M. Sturgis1, F. M. Johnson1, B. Elgohari1, H. Elhalawani1, A. S. Mohamed1, D. I. Rosenthal1, H. D. Skinner3, G. B. Gunn1, J. Phan4, S. J. Frank1, C. D. Fuller1, and A. S. Garden1; 1The University of Texas MD Anderson Cancer Center, Houston, TX, 2The University of Texas Health Science Center San Antonio, San Antonio, TX, 3Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 4Dept. of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

Purpose/Objective(s): Radiation-induced lymphopenia have been associated with poor survival outcomes in certain solid tumors such as breast, colorectal, lung, cervical and pancreatic cancers. We aim to determine the effect of treatment-related lymphopenia during radiotherapy on outcomes of patients with oropharyngeal cancer.

Materials/Methods: A retrospective analysis of patients who completed definitive radiotherapy for oropharyngeal cancer and had blood counts taken during radiotherapy from 2002 to 2013 were included. Patient, tumor and treatment characteristics, clinical outcomes and lymphocyte counts during radiotherapy were recorded. Lymphopenia was graded according to the CTCAE v4.0. Survival rates were estimated using the Kaplan-Meier method and compared with log-rank tests.

Results: 850 patients were evaluated. The median age was 57 years. The most common primary sites were base of tongue (55%) and tonsil (43%). The majority of the cohort had p16/HPV-positive disease (71%), 8% had HPV-negative disease and 21% were unknown. The median radiation total dose was 70 Gy. 45% of patients had induction chemotherapy, and 87% had concurrent chemotherapy. 703 (83%) patients developed ≥grade 3 (G3) lymphopenia and 209 (25%) had grade 4 (G4) lymphopenia during radiotherapy. The median follow-up was 59 months; the 5-year overall survival rate was 81%. There were no significant differences in overall survival rates nor in disease control rates, in those who developed G3/G4 lymphopenia compared with those who did not. No significant effect of lymphopenia on survival was observed when analyzed according to p16/HPV status.

Conclusion: In this large cohort of patients with oropharyngeal cancer, the development of lymphopenia during radiotherapy did not impact outcomes.

Author Disclosure: S. Ng: Employee; The University of Texas MD Anderson Cancer Center. H. Bahig: None. A. Jethanandani: None. C. Pollard: None. E.M. Sturgis: None. B. Elgohari: None. H. Elhalawani: None. D.I. Rosenthal: Advisory Board; BMS. G.B. Gunn: Associate Medical Director; MD Anderson Cancer Center - Proton Therapy. J. Phan: None. S.J. Frank: Research Grant; C4 Imaging, ELEKTA, U19. Founder and Director; C4 Imaging. Honoraria; ELEKTA, Varian Medican Systems, Inc. Advisory Board; Varian Medican Systems, Inc. Stock; C4 Imaging. Royalty; C4 Imaging. Patent/License Fees/Copyright; C4 Imaging. Chairman; American Brachytherapy Society. Director; C4 Imaging. Director-at-large; North America Skull Base Society. C.D. Fuller: Research Grant; National Institutes of Health, National Science Foundation, Elekta AB. Grant funding; Elekta AB. Honoraria; Nederlandse Organisatie voor Wetenschappelijk Onde. Consultant; Elekta AB, Nederlandse Organisatie voor Wetenschappelijk Onde. Travel Expenses; Elekta AB, Nederlandse Organisatie voor Wetenschappelijk Onde. Reviewer; Radiological Society of North America. Associate Editor; Radiographics. Data Management Task Force Committee Member; MR-LinAc Consortium. Member; National Cancer Institute. Task Group Member; American Association of Physicists in Medicine.

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