Lymphocyte damage in four differently treated prostate radiotherapy cohort

  1. Zsuzsa S. Kocsis
  2. Péter Ágoston
  3. Gyöngyi Farkas
  4. Gábor Székely
  5. Gyöngyvér Orsolya Sándor
  6. Kliton Jorgo
  7. László Gesztesi
  8. Tibor Major
  9. Csilla Pesznyák
  10. András Herein
  11. Gábor Stelczer
  12. Dalma Mihály
  13. Georgina Fröhlich
  14. Zoltán Takácsi-Nagy
  15. Csaba Polgár
  16. Zsolt Jurányi
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Abstract

Background

As the assessment of lymphocyte damage caused by radiotherapy gains importance as immunotherapies are used more frequently. Furthermore, there is scarce data to compare the biological dose of radiotherapy techniques in the same patient group.

Methods

Applying chromosome aberration technique, a five-year long (at 3, 6, 9, 12, 24, 36, 48, 60 months) prospective comparison of the biological impact of four different types of treatments for low- and intermediate-risk prostate cancer was performed (195 patients): conventional LINAC (linear accelerator) (70-78 Gy) and Cyberknife (40-37.5 Gy) teletherapy, LDR (low dose rate brachytherapy, 145 Gy) and HDR (high dose rate brachytherapy 19/21 Gy). Multivariate regression analyses were performed to analyze the predictive potential of the chromosome aberrations on side effects. The median follow-up was 48-60 months.

Results

We have found that teletherapy techniques (conv. LINAC and Cyberknife therapy) caused 1.7–3.2-fold more chromosomal aberrations than brachytherapies. At three months, 4.6%– 12.7% of the lymphocytes were damaged. Five years after treatment, the total aberration values of conventional LINAC and LDR brachytherapy patients were still significantly higher than before the therapy (p=0.035 for LINAC and p=0.003 for LDR BT). We found significant regression models suggesting chromosome aberration might predict side effects beside radiation dose and irradiated volumes (V 100% ): Late genitourinary (GU) side effects were dependent of chromosome fragments directly after conv. LINAC therapy (p=0.005).

Conclusions

We demonstrated long-term lymphocyte damage dependent on the type of radiotherapy. We also found less biological dose and side effects in brachytherapy patients.

Highlights

  • Fewer chromosomal aberrations arose after brachytherapies than after teletherapies

  • 12% of the lymphocytes were damaged three months after conventional LINAC therapy

  • Total aberrations were still higher at five years after LDR BT than at baseline

Article activity feed

  1. Version published to 10.1101/2025.05.07.652586v1 on bioRxiv