Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancerCitation formats

  • External authors:
  • James Price
  • Guy Betts
  • Lynne Dixon
  • Kate Garcez
  • Zsuzsanna Iyizoba-Ebozue
  • Lip Lee
  • Andrew Mcpartlin
  • Savvas Papageorgiou
  • Robin Prestwich
  • Dylan Pritchard
  • Andrew J. Sykes
  • David Thomson

Standard

Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancer. / Price, James; Mistry, Hitesh; Betts, Guy; Cheadle, Eleanor; Dixon, Lynne; Garcez, Kate; Illidge, Timothy; Iyizoba-Ebozue, Zsuzsanna ; Lee, Lip; Mcpartlin, Andrew; Papageorgiou, Savvas ; Prestwich, Robin; Pritchard, Dylan; Sykes, Andrew J.; West, Catharine; Thomson, David.

In: Journal of Clinical Oncology, 09.03.2022.

Research output: Contribution to journalArticlepeer-review

Harvard

Price, J, Mistry, H, Betts, G, Cheadle, E, Dixon, L, Garcez, K, Illidge, T, Iyizoba-Ebozue, Z, Lee, L, Mcpartlin, A, Papageorgiou, S, Prestwich, R, Pritchard, D, Sykes, AJ, West, C & Thomson, D 2022, 'Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancer', Journal of Clinical Oncology.

APA

Price, J., Mistry, H., Betts, G., Cheadle, E., Dixon, L., Garcez, K., Illidge, T., Iyizoba-Ebozue, Z., Lee, L., Mcpartlin, A., Papageorgiou, S., Prestwich, R., Pritchard, D., Sykes, A. J., West, C., & Thomson, D. (Accepted/In press). Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancer. Journal of Clinical Oncology.

Vancouver

Author

Price, James ; Mistry, Hitesh ; Betts, Guy ; Cheadle, Eleanor ; Dixon, Lynne ; Garcez, Kate ; Illidge, Timothy ; Iyizoba-Ebozue, Zsuzsanna ; Lee, Lip ; Mcpartlin, Andrew ; Papageorgiou, Savvas ; Prestwich, Robin ; Pritchard, Dylan ; Sykes, Andrew J. ; West, Catharine ; Thomson, David. / Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancer. In: Journal of Clinical Oncology. 2022.

Bibtex

@article{ef552c4c6d0048c496fb8e284be0b2bc,
title = "Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancer",
abstract = "PURPOSEThere is a need to refine the selection of patients with oropharynx squamous cell carcinoma (OPSCC) for treatment de-escalation. We investigated whether pre-treatment absolute lymphocyte count (ALC) predicted overall survival (OS) benefit from the addition of concurrent chemotherapy to radical radiotherapy.PATIENTS AND METHODSThis was an observational study of consecutive OPSCCs treated by curative intent radiotherapy, with or without concurrent chemotherapy (n = 791) with external, independent validation from a separate institution (n = 609). The primary endpoint was OS at 5 years. Locoregional control (LRC) was assessed using competing risk regression as a secondary endpoint. Previously determined prognostic factors were used in a multivariable Cox proportional hazards analysis to assess the prognostic importance of ALC and the interaction between ALC and cisplatin use.RESULTSPre-treatment ALC was prognostic for 5-year OS on multivariable analysis (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.42-0.98, p=0.04). It also predicted benefit from the use of concurrent cisplatin, with a significant interaction between cisplatin and pre-treatment ALC (likelihood ratio-test, p=0.04): higher ALC count reduced the 5-year OS benefit compared to radiotherapy alone (HR 2.53, 95% CI 1.03-6.19, p=0.043). This was likely driven by an effect on LRC up to 5 years (interaction sub-distribution HR 2.29, 95% CI 0.68-7.71, p=0.094). An independent validation cohort replicated the OS (HR 2.53, 95% CI 0.98-6.52, p=0.055) and LRC findings (interaction sub-distribution HR 3.43, 95% CI 1.23-9.52, p=0.018).CONCLUSIONFor OPSCC, the pre-treatment ALC is prognostic for OS and also predicts benefit from the addition of cisplatin to radiotherapy. These findings require prospective evaluation, and could inform the selection of good prognosis patients for a de-escalation trial.",
author = "James Price and Hitesh Mistry and Guy Betts and Eleanor Cheadle and Lynne Dixon and Kate Garcez and Timothy Illidge and Zsuzsanna Iyizoba-Ebozue and Lip Lee and Andrew Mcpartlin and Savvas Papageorgiou and Robin Prestwich and Dylan Pritchard and Sykes, {Andrew J.} and Catharine West and David Thomson",
year = "2022",
month = mar,
day = "9",
language = "English",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",

}

RIS

TY - JOUR

T1 - Pre-treatment lymphocyte count predicts benefit from concurrent chemotherapy with radiotherapy in oropharynx cancer

AU - Price, James

AU - Mistry, Hitesh

AU - Betts, Guy

AU - Cheadle, Eleanor

AU - Dixon, Lynne

AU - Garcez, Kate

AU - Illidge, Timothy

AU - Iyizoba-Ebozue, Zsuzsanna

AU - Lee, Lip

AU - Mcpartlin, Andrew

AU - Papageorgiou, Savvas

AU - Prestwich, Robin

AU - Pritchard, Dylan

AU - Sykes, Andrew J.

AU - West, Catharine

AU - Thomson, David

PY - 2022/3/9

Y1 - 2022/3/9

N2 - PURPOSEThere is a need to refine the selection of patients with oropharynx squamous cell carcinoma (OPSCC) for treatment de-escalation. We investigated whether pre-treatment absolute lymphocyte count (ALC) predicted overall survival (OS) benefit from the addition of concurrent chemotherapy to radical radiotherapy.PATIENTS AND METHODSThis was an observational study of consecutive OPSCCs treated by curative intent radiotherapy, with or without concurrent chemotherapy (n = 791) with external, independent validation from a separate institution (n = 609). The primary endpoint was OS at 5 years. Locoregional control (LRC) was assessed using competing risk regression as a secondary endpoint. Previously determined prognostic factors were used in a multivariable Cox proportional hazards analysis to assess the prognostic importance of ALC and the interaction between ALC and cisplatin use.RESULTSPre-treatment ALC was prognostic for 5-year OS on multivariable analysis (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.42-0.98, p=0.04). It also predicted benefit from the use of concurrent cisplatin, with a significant interaction between cisplatin and pre-treatment ALC (likelihood ratio-test, p=0.04): higher ALC count reduced the 5-year OS benefit compared to radiotherapy alone (HR 2.53, 95% CI 1.03-6.19, p=0.043). This was likely driven by an effect on LRC up to 5 years (interaction sub-distribution HR 2.29, 95% CI 0.68-7.71, p=0.094). An independent validation cohort replicated the OS (HR 2.53, 95% CI 0.98-6.52, p=0.055) and LRC findings (interaction sub-distribution HR 3.43, 95% CI 1.23-9.52, p=0.018).CONCLUSIONFor OPSCC, the pre-treatment ALC is prognostic for OS and also predicts benefit from the addition of cisplatin to radiotherapy. These findings require prospective evaluation, and could inform the selection of good prognosis patients for a de-escalation trial.

AB - PURPOSEThere is a need to refine the selection of patients with oropharynx squamous cell carcinoma (OPSCC) for treatment de-escalation. We investigated whether pre-treatment absolute lymphocyte count (ALC) predicted overall survival (OS) benefit from the addition of concurrent chemotherapy to radical radiotherapy.PATIENTS AND METHODSThis was an observational study of consecutive OPSCCs treated by curative intent radiotherapy, with or without concurrent chemotherapy (n = 791) with external, independent validation from a separate institution (n = 609). The primary endpoint was OS at 5 years. Locoregional control (LRC) was assessed using competing risk regression as a secondary endpoint. Previously determined prognostic factors were used in a multivariable Cox proportional hazards analysis to assess the prognostic importance of ALC and the interaction between ALC and cisplatin use.RESULTSPre-treatment ALC was prognostic for 5-year OS on multivariable analysis (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.42-0.98, p=0.04). It also predicted benefit from the use of concurrent cisplatin, with a significant interaction between cisplatin and pre-treatment ALC (likelihood ratio-test, p=0.04): higher ALC count reduced the 5-year OS benefit compared to radiotherapy alone (HR 2.53, 95% CI 1.03-6.19, p=0.043). This was likely driven by an effect on LRC up to 5 years (interaction sub-distribution HR 2.29, 95% CI 0.68-7.71, p=0.094). An independent validation cohort replicated the OS (HR 2.53, 95% CI 0.98-6.52, p=0.055) and LRC findings (interaction sub-distribution HR 3.43, 95% CI 1.23-9.52, p=0.018).CONCLUSIONFor OPSCC, the pre-treatment ALC is prognostic for OS and also predicts benefit from the addition of cisplatin to radiotherapy. These findings require prospective evaluation, and could inform the selection of good prognosis patients for a de-escalation trial.

M3 - Article

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

ER -