METHODS article
Front. Oncol.
Sec. Radiation Oncology
Influencing factors of lymphopenia after conventional fractionated whole-breast radiotherapy following breast-conserving surgery for early breast cancer:a retrospective study
Provisionally accepted
- Department of Intensive Care Unit, Zhangjiagang First People's Hospital, Zhangjiagang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective To explore the risk factors for grade 2 or higher lymphocytopenia during whole-breast radiotherapy after breast-conserving surgery for breast cancer. Methods A total of 112 patients who underwent whole-breast radiotherapy after breast-conserving surgery for breast cancer in our department from June 2019 to June 2024 were selected and divided into No/Mild Lymphopenia Group (no or grade 1 lymphocytopenia, 48 cases)and Moderate/Severe Lymphopenia Group (grade 2 or higher lymphocytopenia, 64 cases). Univariate and multivariate logistic regression analyses were performed on the clinical data and dosimetric parameters of the two groups to identify the independent risk factors for grade 2 or higher lymphocytopenia. The predictive efficacy of the risk factors was established using the receiver operating characteristic (ROC)curve. Results The analysis of univariate logistic regression indicated that there were statistically significant differences between the two groups in terms of whether received chemotherapy, the quantity of chemotherapy cycles, initial lymphocyte count prior to chemotherapy and radiotherapy, and dosimetric parameters such as the mean dose (Dmean), doses received by 40%, 60%, and 80% of the sternum volume (D40, D60, D80), and the volume of the sternum receiving 5 Gy (V5) (OR range: 0.092~3.927, P<0.05). Multivariate logistic regression analysis revealed that lymphocytopenia prior to chemotherapy and an elevated D80 of the sternum were independent predictors for grade 2 or higher lymphocytopenia (OR range: 0.287~1.517, P<0.05). ROC curve analysis determined that the optimal threshold values for initial lymphocyte count prior to chemotherapy and D80 of the sternum were 1.775×10^9/L and 2.85 Gy, respectively. The Area Under the Curve (AUC)values were 0.787 and 0.7, with corresponding sensitivities of 82.8% and 75.6%, and specificities of 70.4% and 76.7%, respectively. Conclusion Lymphocytes<1.775×10^9/L before chemotherapy and D80 of the sternum>2.85 Gy are independent risk factors for grade 2 or higher lymphocytopenia during whole-breast radiotherapy after breast-conserving surgery for breast cancer.
Keywords: Breast tumor, Conventional whole-breast radiotherapy, Dosimetry, Lymphopenia, Sternum
Received: 22 Jul 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Sun, Chen, Liu, Pan, Gu, Liang, Shen and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lixian Xu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.