{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:33:11Z","timestamp":1787841191271,"version":"build-2784847793"},"reference-count":56,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Radiation therapy is a cornerstone of treatment for solid tumors, yet it often induces lymphopenia, a condition linked to poorer clinical outcomes. This scoping review synthesizes evidence from systematic reviews to evaluate the prognostic impact of severe radiation-induced lymphopenia (RIL) on overall survival (OS) in patients with solid tumors. A systematic literature search was conducted across PubMed, Cochrane Central, and EMBASE using the following keywords: \u201cradiation,\u201d \u201clymphopenia,\u201d \u201csolid tumors,\u201d \u201csurvival AND mortality,\u201d and \u201csystematic review AND meta-analysis,\u201d up to November 30, 2023. Reviews reporting the prognostic relationship between RIL and survival were included, and pooled adjusted hazard ratios (aHRs) were calculated using a random-effects model. Subgroup analyses examined the impact of grade 3 or higher RIL across different tumor types. Of 21 identified reviews, 10 were included, covering 93 studies and 11,565 patients. The adjusted incidence rate of severe lymphopenia averaged 26.7% (range: 18.6\u201388.0%). The pooled aHR for OS was 1.72 (95% CI: 1.33\u20131.87) for grade \u22653 RIL versus grade 0\u20132 RIL, and 1.59 (95% CI: 1.31\u20131.92) for grade 4 RIL versus grade 0-3 RIL. Significant prognostic effects were observed in esophageal, head and neck, pancreatic, cervical, central nervous system, and lung cancers. Genitourinary tumors showed associations with medium-high radiation doses to pelvic and iliac bone marrow. Severe RIL consistently predicts poorer OS, emphasizing the need for prospective studies to address RIL prevention and management, especially in the era of immunotherapy.<\/jats:p>","DOI":"10.4103\/jcrt.jcrt_1997_25","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:06:42Z","timestamp":1774876002000},"page":"3-8","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Severe radiation-induced lymphopenia and its impact on overall survival in solid tumors: A scoping review of systematic reviews"],"prefix":"10.4103","volume":"22","author":[{"given":"Shen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada"},{"name":"University of Manitoba, Winnipeg, Manitoba, 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