{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:40:33Z","timestamp":1777876833634,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["YXH2022ZX02203"],"award-info":[{"award-number":["YXH2022ZX02203"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2024LZL006"],"award-info":[{"award-number":["ZR2024LZL006"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"national natural science foundation of china","doi-asserted-by":"publisher","award":["82573454"],"award-info":[{"award-number":["82573454"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"natural science foundation of shandong province","doi-asserted-by":"publisher","award":["ZR2025LZL016"],"award-info":[{"award-number":["ZR2025LZL016"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"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":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The spleen, the largest secondary lymphoid organ, plays an essential role in systemic immune regulation. Its function in tumor progression and treatment response has gained increasing attention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the prognostic value of spleen volume (SV) change in patients with extensive-stage small-cell lung cancer (ES-SCLC) receiving first-line chemo-immunotherapy (CIT) and to explore its associations with tumor-infiltrating lymphocytes (TILs) and peripheral immune parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A single-center retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 292 ES-SCLC patients who received first-line CIT were retrospectively analyzed. SV was measured on baseline and post-treatment CT scans, and the relative change was used to classify patients into increased or decreased SV groups. Cox proportional hazards regression models were used to assess the effects of SV metrics, immune-related indices, and clinicodemographic factors on overall survival (OS) and progression-free survival (PFS). Objective response rate (ORR) differences were tested using the chi-square test, and immune parameters were compared using Wilcoxon rank-sum tests and correlation analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Multivariate analysis identified increased SV after CIT as an independent adverse prognostic factor for both OS (hazard ratio (HR)\u2009=\u20091.561, 95% confidence interval (CI), 1.193\u20132.041,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001) and PFS (HR\u2009=\u20091.411, 95% CI, 1.106\u20131.800,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006). Patients with increased SV exhibited significantly shorter OS and PFS and a lower ORR (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.005). Increased SV was also associated with markedly lower total, CD4+, and CD8+ TIL densities and, at the systemic level, lower absolute lymphocyte count (ALC), and higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), indicating both local and systemic immune suppression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>SV change reflects both local and systemic immune remodeling during CIT in ES-SCLC. As a noninvasive and measurable imaging biomarker, SV change holds translational potential for immune monitoring and treatment response assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359261417776","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T02:39:36Z","timestamp":1771036776000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spleen volume change as a prognostic and immunologic imaging biomarker in extensive-stage small-cell lung cancer receiving chemo-immunotherapy"],"prefix":"10.1177","volume":"18","author":[{"given":"Xiuli","family":"Liu","sequence":"first","affiliation":[{"name":"Shandong University Cancer Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ao","family":"Liu","sequence":"additional","affiliation":[{"name":"Shandong University Cancer Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China"},{"name":"Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Defeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Shandong University Cancer Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanlin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiazhong","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, PET-CT Center, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhichao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuqing","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5933-9912","authenticated-orcid":false,"given":"Jinming","family":"Yu","sequence":"additional","affiliation":[{"name":"Shandong University Cancer Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250117, China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6112-7038","authenticated-orcid":false,"given":"Minghuan","family":"Li","sequence":"additional","affiliation":[{"name":"Shandong University Cancer Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250117, China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 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