Lymphocytopenia and Cytotoxic Therapy in Patients with Advanced Ovarian Cancer
Cancer Research Journal
Volume 3, Issue 3, May 2015, Pages: 47-51
Received: Apr. 13, 2015; Accepted: Apr. 25, 2015; Published: May 12, 2015
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Alexei N. Shoutko, Laboratory of the development of radiation therapy methods, Federal Scientific Centre for Radiology and Surgical Technologies, Saint-Petersburg, Russian Federation
Ludmila E. Yurkova, Division of Gynecologic Oncology, Federal Scientific Centre for Radiology and Surgical Technologies, Saint-Petersburg, Russian Federation
Kseniya S. Borodulya, Division of Gynecologic Oncology, Federal Scientific Centre for Radiology and Surgical Technologies, Saint-Petersburg, Russian Federation
Ludmila P. Ekimova, Laboratory of the development of radiation therapy methods, Federal Scientific Centre for Radiology and Surgical Technologies, Saint-Petersburg, Russian Federation
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The relationship between 5-year survival and the mean number of circulating lymphocytes during 1 month after beginning a combined therapy was investigated in 175 patients with advanced epithelial ovarian cancer to understand why myelosuppression caused by a cytotoxic treatment is almost inseparable from its benefit. Patients received a combined therapy consisting of primary cytoreductive surgery followed by different systemic treatments according to three schemes: conventional chemotherapy with cisplatinum and cyclophosphanum (CP), conventional chemotherapy with paclitaxel and carboplatinum (TP), or lower-half body irradiation (LHBI). The TP scheme included premedication with dexamethasone. The LHBI involve irradiation with a total dose of 9 Gy (3 Gy daily) in patients with primary disease. LHBI with a total dose of 1 Gy (0.1 Gy daily) was used for patients with primary disease or relapse. The LHBI treatment included five final courses of thiophosphamide/5-fluorouracil for patients with primary cancer or conventional local radiotherapy up to a total dose of 30 Gy (2 Gy daily) for relapsed patients. Survival curves were analyzed by exponential approximation, and 5-year exponential mortality rates were calculated. The mortality rates were compared with the relative decline in the mean number of circulating lymphocytes after 1 month of therapy. If pretreatment lymphocytopenia did not exceed 0.7 109 cells /L, a linear dependency of the exponential death rate from the relative deviation of cells in the range of 1.16 to 0.7 (p < 0.001) was observed. The inevitable side effect of cytotoxic cancer therapy in the form of lymphocytopenia sheds doubt on the actual existence of effective antineoplastic immunity; however, it provides a logical background of the morphogenic function of some circulating mononuclear cells in relation to proliferating tissues, including malignant tissues.
Cytotoxic Therapy, Death Rates, Lymphocytopenia, Myelosuppression, Ovarian Cancer, Survival
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Alexei N. Shoutko, Ludmila E. Yurkova, Kseniya S. Borodulya, Ludmila P. Ekimova, Lymphocytopenia and Cytotoxic Therapy in Patients with Advanced Ovarian Cancer, Cancer Research Journal. Vol. 3, No. 3, 2015, pp. 47-51. doi: 10.11648/j.crj.20150303.11
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