{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:04:16Z","timestamp":1791140656639,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172677"],"award-info":[{"award-number":["82172677"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT), the high incidence of radiation\u2010induced lymphopenia significantly affects prognosis. There are significant variations in lymphocyte count (ALC) recovery patterns among patients, and their impact on prognosis remains unclear. This study aims to quantify the lymphocyte recovery patterns by the lymphocyte recovery index (LRI) and evaluate its prognostic value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study reviewed patients with LACC who had ALCs available within 6\u2009months post\u2010CCRT. Lymphopenia was graded using CTCAE 5.0, and lymphocyte recovery patterns were quantified using LRI (the ratio of ALCs at 6\u2009months post\u2010treatment to baseline ALCs). Cox regression analysis was conducted to assess the correlation between LRI, other clinical factors, and survival. The dose\u2013volume of bone marrow (BM) following pelvic radiotherapy was collected, and measurements of spleen standardized uptake value (SUV) and spleen\u2010to\u2010liver SUVmax ratio (SLR) were obtained from pre\u2010treatment 18F\u2010FDG PET\/CT. Logistic regression analysis was used to identify independent risk factors for LRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 180 patients were included retrospectively. During CCRT, 53 patients (29.4%) experienced G4 lymphopenia. The median LRI was 53.4% (range 13.2%\u2013159.4%). Multivariable analysis revealed that LRI, G4 lymphopenia, and FIGO stage were associated with progression\u2010free survival (PFS) and overall survival (OS). Subgroup analysis revealed that the degree of lymphopenia (G4 and G1\u20103) did not affect the correlation between LRI and PFS (P: 0.001 and 0.011) or OS (P: 0.003 and 0.043). Regarding FIGO stage, the impact of LRI on PFS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and OS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) was primarily observed in patients with FIGO stage\u2009&gt;\u2009II. Logistic analysis identified BM\u2010V10\u2009&gt;\u200996.0% and SLR\u2009&gt;\u20090.90 as independent risk factors for LRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with LACC after CCRT, the LRI is associated with prognosis. Splenic metabolism and BM irradiation are associated with lymphocyte recovery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70638","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T13:48:56Z","timestamp":1739540936000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Role of Lymphocyte Recovery Index in Prognosis Prediction for Locally Advanced Cervical Cancer With Radiation\u2010Induced Lymphopenia"],"prefix":"10.1002","volume":"14","author":[{"given":"Yi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Qilu Hospital, Cheeloo College of Medicine, Shandong University  Jinan China"},{"name":"Department of Radiation Oncology Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longxiang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Oncology Dongying People's Hospital  Dongying China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanlin","family":"Li","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine Shandong Second Medical University  Weifang 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