Document Detail


Long-term immune dysfunction after radiotherapy to the head and neck area.
MedLine Citation:
PMID:  12860166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hematological side effects are not generally expected due to radiotherapy involving limited radiation fields; however, patients with squamous cell carcinoma of the head and neck (SCCH and N) receiving radiation therapy frequently have chronic intraoral infections. Xerostomia has been implicated as a cause of it, but local or systemic immune alterations are not usually considered. METHODS: With the purpose of evaluating the impact of radiotherapy treatment to different anatomic sites on immune function, 70 patients were evaluated during and after radiotherapy: 50 cases with SCCH and N, 10 with squamous cell carcinoma of the uterine cervix (SCCUC) and 10 patients with central nervous system tumors (CNS). We analyzed lymphocyte counts and T-cell subsets, and over time, their association with the presence of intracellular infections and disease-free survival. RESULTS: Severe lymphopenia was observed in patients with SCCUC and SCCH and N by the fifth week of treatment. Patients with CNS tumors developed mild lymphopenia. In patients with SCCH and N and UC, lower counts were seen in B cells and total T lymphocyte counts including both CD4(+) and CD8(+) cell subsets. The patients with SCCUC recovered lymphocyte counts by the 24th month but T-cell subsets lagged behind. None of the SCCH and N patients had fully recovered by 60 months of follow-up. Recurrence correlates with low lymphocyte counts. DISCUSSION: This work highlights the vulnerability of the head and neck area to the impact of radiotherapy as a reservoir of lymphoid cells. The possibility of recovery as a consequence of thymopoiesis and/or peripheral clonal expansion may limit the antigen-specific recognition of relevant tumor or microbial antigens and cause significant and prolonged immune alterations that may impact long-term survival.
Authors:
Emma L Verastegui; Rocio B Morales; Jose L Barrera-Franco; Adela C Poitevin; John Hadden
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International immunopharmacology     Volume:  3     ISSN:  1567-5769     ISO Abbreviation:  Int. Immunopharmacol.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-15     Completed Date:  2004-03-29     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  100965259     Medline TA:  Int Immunopharmacol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1093-1104     Citation Subset:  IM    
Affiliation:
Department of Immunology, Instituto Nacional de Cancerologia, Avenida San Fernando 22, Tlalpan 14000 D.F., México City, Mexico. incaninm@mexis.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Central Nervous System Neoplasms / immunology,  radiotherapy
Female
Follow-Up Studies
Head and Neck Neoplasms / immunology,  radiotherapy*
Humans
Immunologic Memory / immunology,  radiation effects
Lymphocyte Count
Lymphopenia / etiology,  immunology*
Male
Middle Aged
Neoplasms, Squamous Cell / immunology,  radiotherapy*
Prospective Studies
Radiotherapy / adverse effects*
T-Lymphocyte Subsets / immunology,  radiation effects
Time Factors
Uterine Cervical Neoplasms / immunology,  radiotherapy

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