{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:59:15Z","timestamp":1790665155365,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We analyzed the relationship among peripheral blood lymphocytes, exposed sternum and vertebra body bone marrow (BM), and overall survival (OS) to find BM dosimetric parameters of lymphopenia during chemoradiotherapy (CRT) for patients with esophageal squamous cell carcinoma (ESCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We examined 476 ESCC patients from January 2012 to January 2015, all of whom received concurrent or sequential CRT. Absolute lymphocyte counts (ALC) during radiotherapy (RT) of each patient were collected from the routine workup at the following RT times: pretreatment ALC (ALC0), at 1\u20135, 6\u201310, 11\u201315, 16\u201320, and 21\u201325, and more than 26 sessions (called ALC1\u20136, respectively). The sternum and vertebral body BM were delineated in accordance with uniform standards, and the irradiated volumes were calculated by dose\u2010volume histograms (DVH). The Kaplan\u2013Meier method and Cox proportional hazards regression were used to analyze the survival of the patients. Comparisons of DVH were performed using the Mann\u2013Whitney U test or two\u2010sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test where appropriate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A relative volume of sternum BM irradiated by more than 20\u00a0Gy could clearly affect the peripheral blood lymphocytes. The V20 of sternum BM and V50 of vertebra body BM were related to the OS of the patients, and the level of ALC2 (at 6\u201310 times of RT) could predict the outcomes of patients. The Cox regression analyses showed that the 218 patients with ALC2\u00a0\u2265\u00a00.8\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L had a significantly higher OS (47.0\u00a0months vs. 30.9\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001) than the 258 patients with ALC2\u00a0&lt;\u00a00.8\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In patients with ESCC, the relative volume of sternum BM irradiated by more than 20\u00a0Gy was associated with lymphocytes. Patients with ALC2\u00a0\u2265\u00a00.8\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L had a significantly higher OS. The V20 of the sternum BM, the V50 of the vertebra body BM, and the level of ALC2 were significant prognostic factors in patients with ESCC.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.4131","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T06:58:53Z","timestamp":1628319533000},"page":"5847-5858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Bone marrow dosimetric analysis of lymphopenia in patients with esophageal squamous cell carcinoma treated with chemoradiotherapy"],"prefix":"10.1002","volume":"10","author":[{"given":"Qian","family":"Wang","sequence":"first","affiliation":[{"name":"Cheeloo College of Medicine Shandong University Jinan China"},{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan 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