{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T04:15:53Z","timestamp":1793506553256,"version":"4.5.0"},"reference-count":37,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","redjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Radiation Oncology*Biology*Physics"],"published-print":{"date-parts":[[2024,2]]},"DOI":"10.1016\/j.ijrobp.2023.08.058","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T12:11:17Z","timestamp":1693311077000},"page":"368-377","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":40,"title":["Severe Lymphopenia During Chemoradiation Therapy for Esophageal Cancer: Comprehensive Analysis of Randomized Phase 2B Trial of Proton Beam Therapy Versus Intensity Modulated Radiation Therapy"],"prefix":"10.1016","volume":"118","author":[{"given":"Xin","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.N.","family":"van Rossum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"Hobbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Grassberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore S.","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxing","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinzhong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tucker","family":"Netherton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhe","family":"Mohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4411-0634","authenticated-orcid":false,"given":"Steven H.","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijrobp.2023.08.058_bib0001","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jamaoncol.2019.2996","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study","volume":"5","year":"2019","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0002","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1001\/jama.281.17.1623","article-title":"Chemoradiotherapy of locally advanced esophageal cancer: Long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group","volume":"281","author":"Cooper","year":"1999","journal-title":"JAMA"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0003","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1056\/NEJMoa1112088","article-title":"Preoperative chemoradiotherapy for esophageal or junctional cancer","volume":"366","author":"van Hagen","year":"2012","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0004","doi-asserted-by":"crossref","first-page":"224","DOI":"10.2307\/3577549","article-title":"Radiosensitivity of CD4 or CD8 positive human T-lymphocytes by an in vitro colony formation assay","volume":"123","author":"Nakamura","year":"1990","journal-title":"Radiat Res"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0005","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/S0360-3016(00)00769-0","article-title":"Effects of concurrent cisplatinum administration during radiotherapy versus. radiotherapy alone on the immune function of patients with cancer of the uterine cervix","volume":"48","author":"Santin","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0006","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/S0140-6736(72)91091-4","article-title":"Lymphopenia and change in distribution of human B and T lymphocytes in peripheral blood induced by irradiation for mammary carcinoma","volume":"1","author":"Stjernsward","year":"1972","journal-title":"Lancet"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0007","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1080\/1744666X.2017.1366315","article-title":"Immunotherapy of cancers comes of age","volume":"13","author":"Yousefi","year":"2017","journal-title":"Expert Rev Clin Immunol"},{"issue":"suppl 1","key":"10.1016\/j.ijrobp.2023.08.058_bib0008","first-page":"E1061","article-title":"Minimum absolute lymphocyte count during radiotherapy as a new prognostic factor for nasopharyngeal cancer","volume":"38","author":"Cho","year":"2016","journal-title":"Head Neck"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0009","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ijrobp.2018.01.069","article-title":"Effect of radiation treatment volume reduction on lymphopenia in patients receiving chemoradiotherapy for glioblastoma","volume":"101","author":"Rudra","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0010","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.ijrobp.2014.04.025","article-title":"Lymphopenia association with gross tumor volume and lung V5 and its effects on non-small cell lung cancer patient outcomes","volume":"89","author":"Tang","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0011","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/COC.0b013e3182940ff9","article-title":"The association between chemoradiation-related lymphopenia and clinical outcomes in patients with locally advanced pancreatic adenocarcinoma","volume":"38","author":"Wild","year":"2015","journal-title":"Am J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0012","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ygyno.2015.11.013","article-title":"Lymphopenia and its association with survival in patients with locally advanced cervical cancer","volume":"140","author":"Wu","year":"2016","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0013","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ijrobp.2017.05.037","article-title":"Lymphocyte nadir and esophageal cancer survival outcomes after chemoradiation therapy","volume":"99","author":"Davuluri","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0014","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.ijrobp.2021.07.1695","article-title":"The influence of severe radiation-induced lymphopenia on overall survival in solid tumors: A systematic review and meta-analysis","volume":"111","author":"Damen","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0015","doi-asserted-by":"crossref","first-page":"S87","DOI":"10.3747\/co.27.5223","article-title":"A review of cancer immunotherapy: From the past, to the present, to the future","volume":"27","author":"Esfahani","year":"2020","journal-title":"Curr Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0016","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/j.ijrobp.2015.04.005","article-title":"Clinical and dosimetric predictors of acute severe lymphopenia during radiation therapy and concurrent temozolomide for high-grade glioma","volume":"92","author":"Huang","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0017","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.radonc.2021.01.034","article-title":"Risk and impact of radiation related lymphopenia in lung cancer: A systematic review and meta-analysis","volume":"157","author":"Upadhyay","year":"2021","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0018","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.ijrobp.2016.10.046","article-title":"Does unintentional splenic radiation predict outcomes after pancreatic cancer radiation therapy?","volume":"97","author":"Chadha","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0019","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.21873\/invivo.11409","article-title":"Spleen dose-volume parameters as a predictor of treatment-related lymphopenia during definitive chemoradiotherapy for esophageal cancer","volume":"32","author":"Saito","year":"2018","journal-title":"In Vivo"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0020","doi-asserted-by":"crossref","first-page":"R155","DOI":"10.1088\/0031-9155\/60\/8\/R155","article-title":"The physics of proton therapy","volume":"60","author":"Newhauser","year":"2015","journal-title":"Phys Med Biol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0021","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1200\/JCO.19.02503","article-title":"Randomized phase IIB trial of proton beam therapy versus intensity-modulated radiation therapy for locally advanced esophageal cancer","volume":"38","author":"Lin","year":"2020","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0022","doi-asserted-by":"crossref","first-page":"103","DOI":"10.2307\/2529712","article-title":"Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial","volume":"31","author":"Pocock","year":"1975","journal-title":"Biometrics"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0023","doi-asserted-by":"crossref","first-page":"5592","DOI":"10.1002\/mp.14415","article-title":"Evaluation of a multiview architecture for automatic vertebral labeling of palliative radiotherapy simulation CT images","volume":"47","author":"Netherton","year":"2020","journal-title":"Med Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0024","unstructured":"Therneau T, Atkinson B. rpart: Recursive partitioning and regression trees. R package version 4.1.16. https:\/\/CRAN.R-project.org\/package=rpart. Accessed December 22, 2023"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0025","doi-asserted-by":"crossref","first-page":"23","DOI":"10.14338\/IJPT-17-00033.1","article-title":"Lymphocyte-sparing effect of proton therapy in patients with esophageal cancer treated with definitive chemoradiation","volume":"4","author":"Fang","year":"2018","journal-title":"Int J Part Ther"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0026","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.radonc.2017.11.028","article-title":"Severe lymphopenia during neoadjuvant chemoradiation for esophageal cancer: A propensity matched analysis of the relative risk of proton versus photon-based radiation therapy","volume":"128","author":"Shiraishi","year":"2018","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0027","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.adro.2018.09.004","article-title":"A comparison of grade 4 lymphopenia with proton versus photon radiation therapy for esophageal cancer","volume":"4","author":"Routman","year":"2019","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0028","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1016\/j.prro.2019.07.010","article-title":"Prediction of severe lymphopenia during chemoradiation therapy for esophageal cancer: Development and validation of a pretreatment nomogram","volume":"10","author":"van Rossum","year":"2020","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0029","doi-asserted-by":"crossref","first-page":"2917","DOI":"10.2147\/CMAR.S297010","article-title":"The impact of lymphopenia and dosimetric parameters on overall survival of esophageal cancer patients treated with definitive radiotherapy","volume":"13","author":"Liu","year":"2021","journal-title":"Cancer Manag Res"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0030","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.936684","article-title":"Severe radiation-induced lymphopenia during postoperative radiotherapy or chemoradiotherapy has poor prognosis in patients with stage IIB-III after radical esophagectomy: A post hoc analysis of a randomized controlled trial","volume":"12","author":"Ni","year":"2022","journal-title":"Front Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0031","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1056\/NEJMoa2032125","article-title":"Adjuvant nivolumab in resected esophageal or gastroesophageal junction cancer","volume":"384","author":"Kelly","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0032","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1016\/j.ijrobp.2020.07.2160","article-title":"Safety and efficacy of PD-1 antibody SHR-1210 combined with concurrent chemoradiotherapy to treat locally advanced esophageal squamous cell carcinoma: A phase Ib clinical trial","volume":"108","author":"Pang","year":"2020","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0033","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.lungcan.2021.01.022","article-title":"Association of severe lymphopenia and disease progression in unresectable locally advanced non-small cell lung cancer treated with definitive chemoradiation and immunotherapy","volume":"154","author":"Friedes","year":"2021","journal-title":"Lung Cancer"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0034","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S2213-2600(20)30391-X","article-title":"Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer: A pooled analysis of two randomised trials","volume":"9","author":"Theelen","year":"2021","journal-title":"Lancet Respir Med"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0035","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1200\/JCO.20.00290","article-title":"Randomized phase II trial of nivolumab with stereotactic body radiotherapy versus nivolumab alone in metastatic head and neck squamous cell carcinoma","volume":"39","author":"McBride","year":"2021","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0036","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/onco.13712","article-title":"Avelumab, a PD-L1 inhibitor, in combination with hypofractionated radiotherapy and the abscopal effect in relapsed refractory multiple myeloma","volume":"26","author":"Kazandjian","year":"2021","journal-title":"Oncologist"},{"key":"10.1016\/j.ijrobp.2023.08.058_bib0037","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.radonc.2018.12.002","article-title":"The relationship of lymphocyte recovery and prognosis of esophageal cancer patients with severe radiation-induced lymphopenia after chemoradiation therapy","volume":"133","author":"Deng","year":"2019","journal-title":"Radiother Oncol"}],"container-title":["International Journal of Radiation Oncology*Biology*Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301623078525?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301623078525?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T10:10:21Z","timestamp":1759745421000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0360301623078525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["S0360301623078525"],"URL":"https:\/\/doi.org\/10.1016\/j.ijrobp.2023.08.058","relation":{},"ISSN":["0360-3016"],"issn-type":[{"value":"0360-3016","type":"print"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Severe Lymphopenia During Chemoradiation Therapy for Esophageal Cancer: Comprehensive Analysis of Randomized Phase 2B Trial of Proton Beam Therapy Versus Intensity Modulated Radiation Therapy","name":"articletitle","label":"Article Title"},{"value":"International Journal of Radiation Oncology*Biology*Physics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijrobp.2023.08.058","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}