{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:33:51Z","timestamp":1792503231024,"version":"4.5.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:00:00Z","timestamp":1715126400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Suzhou Medical Center","award":["Szlcyxzx202103"],"award-info":[{"award-number":["Szlcyxzx202103"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171828"],"award-info":[{"award-number":["82171828"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key R&D plan of Jiangsu Province","award":["BE2021652"],"award-info":[{"award-number":["BE2021652"]}]},{"DOI":"10.13039\/501100014358","name":"Second Affiliated Hospital of Soochow University","doi-asserted-by":"publisher","award":["XKTJHRC20210011"],"award-info":[{"award-number":["XKTJHRC20210011"]}],"id":[{"id":"10.13039\/501100014358","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.2021-01-12"],"award-info":[{"award-number":["320.6750.2021-01-12"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Technological Innovation"},{"name":"CNNC Medical Industry Co. 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Radiation-induced lymphopenia has been associated with poorer outcomes in different cancer types. Despite being the largest secondary lymphoid organ, the spleen has not been officially designated as an organ at risk. This study hypothesizes a connection between spleen irradiation and lymphopenia and seeks to establish evidence-based dosage limits for the spleen. We retrospectively analyzed data from 96 patients with locally advanced gastric cancer who received postoperative chemoradiotherapy (CRT) between May 2010 and May 2017. Complete blood counts were collected before, during and after CRT. We established a model for predicting the minimum absolute lymphocyte count (Min ALC) and to investigate potential associations between spleen dosimetric variables and Min ALC. The median follow-up was 60\u00a0months. The 5-year overall survival (OS) and disease-free survival (DFS) were 65.2% and 56.8%, respectively. The median values of pre-treatment ALC, Min ALC and post-treatment ALC were 1.40\u2009\u00d7\u2009109, 0.23\u2009\u00d7\u2009109 and 0.28\u2009\u00d7\u2009109\/L, respectively. Regression analysis confirmed that the primary tumor location, number of fractions and spleen V5 were significant predictors of Min ALC during radiation therapy. Changes in ALC (\u0394ALC) were identified as an independent predictor of both OS and DFS. Spleen V5 is an independent predictor for Min ALC, and the maximum dose of the spleen is associated with an increased risk of severe lymphopenia. Therefore, these doses should be restricted in clinical practice. Additionally, \u0394ALC can serve as a prognostic indicator for adjuvant radiotherapy in gastric cancer.<\/jats:p>","DOI":"10.1093\/jrr\/rrae023","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T20:50:11Z","timestamp":1715201411000},"page":"337-349","source":"Crossref","is-referenced-by-count":10,"title":["The relationship between splenic dose and radiation-induced lymphopenia"],"prefix":"10.1093","volume":"65","author":[{"given":"Yifu","family":"Ma","sequence":"first","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuehong","family":"Kong","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Peng","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Xu","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Xu","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Oncology, Changshu Hospital Affiliated to Soochow University , Shu Yuan Road No. 1, Suzhou 215500 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Nuclear medicine, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Xing","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Qian","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"PRaG Therapy Center , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"The Second Affiliated Hospital of Soochow University , Center for Cancer Diagnosis and Treatment, , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"Institute of Radiotherapy and Oncology, Soochow University , San Xiang Road No. 1055, Suzhou 215004 , China"},{"name":"State Key Laboratory of Radiation Medicine and Protection, Soochow University , Ren Ai Road No. 199, Suzhou 215004 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"2024052320121656700_ref1","doi-asserted-by":"crossref","first-page":"3199","DOI":"10.4049\/jimmunol.139.10.3199","article-title":"Gene induction by gamma-irradiation leads to DNA fragmentation in lymphocytes","volume":"139","author":"Sellins","year":"1987","journal-title":"J Immunol"},{"key":"2024052320121656700_ref2","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1182\/blood.V89.7.2303","article-title":"Radiotherapy-associated neutropenia and thrombocytopenia: analysis of risk factors and development of a predictive model","volume":"89","author":"Mac 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