Abstract 2252: Significant impacts of IMRT on peripheral blood lymphocyte subpopulation and immune globulin levels in head and neck cancer patients
Authors: WU Qiuji , Zhang Shuyuan , LI Zheng , Zhong Yahua 
Published: September 2020

Abstract
Purpose
This study aims at investigate the regulation of peripheral lymphocyte subpopulations and immune globulins in head and neck cancer patients during intensity-modulated radiation therapy (IMRT).
Patients and Methods
Patients with non-metastatic head and neck cancers consecutively treated in our institute by conventional IMRT with or without induction or concomitant chemotherapy from January 2019 to September 2019 were enrolled in this study. Radiation doses were given 68-70Gy to gross tumor volumes, 60-66Gy to high-risk cervical lymphatic draining areas, 54Gy to low-risk lymphatic draining areas. Induction chemotherapy was composed of two to three cycles of triweekly taxanes and platinum salts, and concomitant chemotherapy was composed of weekly or triweekly platinum salts. Data of lymphocyte subpopulation counts and immune globulin levels were collected before, in the middle of and at the end of IMRT. Friedman's two-way ANOVA was used to compare values of indicated time points. Generalized estimating equations (GEE) were used to examine the impacts of induction and concomitant chemotherapy. SPSS (IBM version 23.0) software package was used to perform statistical analysis and P&lt;0.05 was considered statistically significant.
Results
A total of 126 patients were enrolled in this study. There were 86 male and 40 female patients with the median age being 54 (range: 24-82) years. There were 47 patients with nasopharyngeal carcinoma and 79 patients with other head and neck cancers. 44 patients received induction chemotherapy, and 56 received concurrent chemotherapy. Total CD3+ T cells (from 1118.69/μL to 335.57/μL, P&lt;0.001), CD3+CD4+ T cells (from 596.0/μL to 119.5/μL, P&lt;0.001) and CD3+CD8+ T cells (from 408.0/μL to 107.5/μL, P&lt;0.001), CD16+CD56+ NK cells (from 337.74/μL to 150.11/μL, P&lt;0.013), CD19+ B cells (from 147.01/μL to 19.27/μL, P&lt;0.001) counts declined significantly during IMRT. However, the percentage of CD8+ T cells and NK cells increased from 26.34% to 28.06% (P&lt;0.001), and from 20.93% to 29.58% (P&lt;0.001), respectively. Complement C4 also increased from 0.2688g/L to 0.3171g/L (P&lt;0.001). Other items including C3, IgA, IgE, IgG, IgM were not altered significantly during IMRT. GEE analysis indicated that induction chemotherapy impacted significantly on B cell count (P=0.018), IgA (P=0.034) and IgM (P=0.017), while concomitant chemotherapy impacted significantly on CD3+ T cell (P=0.010), CD3+CD4+ T cell (P=0.050) and CD3+CD8+ T cell (P=0.017) counts and IgG (P=0.002), and did not impact significantly on other lymphocyte subpopulations or immune globulins.
Conclusion
IMRT induced a significant alteration in peripheral lymphocyte subpopulations and immune globulins in head and neck patients. Induction and concomitant chemotherapy also impacted on selected components. The clinical relevance of these findings warrants further investigations.
Keywords
Head and neck cancer, IMRT, lymphocyte subpopulation, immune globulin
Citation Format: Qiuji WU, Shuyuan Zhang, Zheng LI, Yahua Zhong. Significant impacts of IMRT on peripheral blood lymphocyte subpopulation and immune globulin levels in head and neck cancer patients [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2252.