Prognostic Value of Severe Lymphopenia During Pelvic Concurrent Chemoradiotherapy in Cervical Cancer

Anticancer Res. 2016 Jul;36(7):3541-7.


Aim: To investigate whether common terminology criteria for adverse events (CTCAE) grade 4 lymphopenia (<200 cells/μl) during concurrent chemoradiotherapy (CCRT) is relevant to poor survival.

Patients and methods: We analyzed 124 patients with newly diagnosed Federation of Gynecology and Obstetrics (FIGO) stage I-III cervical cancer who received weekly cisplatin-based CCRT and brachytherapy using Kaplan-Meier curves and the Cox proportional hazard models.

Results: Grade 4 lymphopenia significantly predicted disease-specific survival (DSS) and progression-free survival (PFS) (adjusted hazard ratio (95% confidence interval (CI))=3.6 (1.37-9.44), p=0.009 and 3.28 (1.27-8.48), p=0.014, respectively). The 5-year DSS and 3-year PFS were significantly higher among patients with grade 2-3 lymphopenia (≥200 cells/μl) than among those with grade 4 lymphopenia (84.8% vs. 50.4%, p<0.001, and 80.7% vs. 50%, p=0.002, respectively).

Conclusion: Severe lymphopenia during CCRT could predict poor survival.

Keywords: Cervical cancer; concurrent chemoradiotherapy; prognosis; severe lymphopenia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brachytherapy
  • Chemoradiotherapy
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Female
  • Humans
  • Lymphopenia / diagnosis
  • Lymphopenia / mortality*
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / therapy*


  • Cisplatin