Radiation-induced lymphopenia and the survival of women with cervical cancer: a meta-analysis

Abstract

The current systematic analysis and meta-analysis was aimed to evaluate the association between radiation-induced lymphopenia (RIL) and survival of women with cervical cancer (CC). PubMed, Embase, Web of Science, and Cochrane Library were searched for relevant cohort studies comparing survival between women with CC who developed versus not developed RIL after radiotherapy. We pooled the results using a random-effects model that incorporates heterogeneity. In the meta-analysis, 952 women with CC were included from eight cohort studies. Overall, 378 (39.7%) of them had RIL after radiotherapy. During a median follow-up duration of 41.8 months, pooled results showed that RIL was independently associated with poor overall survival (hazard ratio [HR]: 2.67, 95% confidence interval [CI]: 1.81 to 3.94, p < 0.001; I² = 20%) and progression-free survival (HR: 2.17, 95% CI: 1.58 to 2.98, p < 0.001; I² = 0%). Predefined subgroup analyses showed similar results in patients with grade 3-4 and grade 4 RIL, in patients with RIL diagnosed during or after the radiotherapy, and in studies with quality score of seven or eight points (p values for subgroup effect all < 0.05). In conclusion, women with RIL were associated with poor survival after radiotherapy for CC.

Keywords:

• Cervical cancer
• radiotherapy
• lymphopenia
• survival
• meta-analysis
• lymphocyte

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

All procedures carried out in studies involving human participants are in accordance with the ethical standards of institutions and/or national research councils, as well as with the 1964 Helsinki Declaration and its subsequent revisions or similar ethical standards. Formal consent is not required for this type of research.

Author contributions

Hongming Cao and Baihui Gu conceived the study. Hongming Cao and Haiyan Yan performed literature search, study identification, quality evaluation, and data collection. Hongming Cao and Shoumin Bai performed statistical analyses and interpreted the results. Hongming Cao and Baihui Gu drafted the manuscript. All authors revised the manuscript and approved the submission.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data used in this paper are from published articles.

Additional information

Funding

No funding was received for this study.