Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival
Table 1
Clinical characteristics of patients with HCC in the overall study cohort.
Characteristic
N = 184
N (%) or median (range)
Gender
Female vs. male
34 (18.5%) vs. 150 (81.5%)
Age (y)
58 (22–87)
KPS
≥90 vs. <90
168 (91.3%) vs. 16 (8.7%)
Child-Pugh
5 vs. 6 vs. ≥7
76 (41.3%) vs. 70 (38.0%) vs.28 (15.3%)
Unknown
10 (5.4%)
BCLC stage
A vs. B vs. C
57 (31%) vs. 71 (38.6%) vs. 50 (27.2%)
Unknown
6 (3.3%)
HBV
Negative vs. positive
47 (25.5%) vs. 137 (74.5%)
AFP (UI/ml)
28.1 (0–60500)
Tumor thrombus
Yes vs. no
32 (17.4%) vs. 152 (82.6%)
LNM
Yes vs. no
22 (12.0%) vs. 162 (88.0%)
TACE
Yes vs. no
109 (59.2%) vs. 75 (40.8%)
RFA
Yes vs. no
18 (9.8%) vs. 166 (90.2%)
Tumor size (cm)
4.1 (0.7–24.0)
ALC pre-RT (×109/L)
1.3 (0.2–3.5)
ALC post-RT (×109/L)
0.5 (0.1–2.2)
Lymphocyte nadir (×109/L)
0.5 (0.1–2.6)
WBC nadir (×109/L)
3.7 (1.5–13.4)
Mono nadir (×109/L)
0.3 (0.1–1.1)
Neut nadir (×109/L)
2.5 (0.7–12.2)
RT fractionation
CFRT vs. HFRT vs. SBRT
53 (37.0%) vs. 58 (31.5%) vs. 73 (31.5%)
BED (Gy)
75.0 (50.0–119.0)
Fractions
16 (5–35)
GTV (cc)
55.0 (1.6–1880.1)
KPS = Karnofsky Performance Status; BCLC stage = Barcelona Clinic Liver Cancer stage; HBV = hepatitis B virus; AFP = alpha-fetoprotein; LNM = lymph node metastasis; TACE = transcatheter arterial chemoembolization; RFA = radiofrequency ablation; ALC = absolute lymphocyte count; ALC pre-RT = ALC within two weeks before the start of RT; ALC post-RT = ALC within 1 week after the end of RT; ALC post-pre = ALC at post-RT minus ALC at pre-RT; WBC = white blood cell; Mono = monocyte; Neut = neutrophil; RT = radiotherapy; BED = biologically effective dose; and GTV = gross target volume.