Lymphopenia, IL6, and CCL2 after thoracic radiotherapy predict poor prognosis in patients with lung cancer.
Journal
Journal of the Formosan Medical Association
Series/Report No.
Journal of the Formosan Medical Association
ISSN
0929-6646
Date Issued
2025-07-08
Author(s)
Abstract
Background/purpose: This study evaluated the impact of lymphopenia and serum biomarkers, including interleukin-6 (IL-6) and chemokine (C–C motif) ligand 2 (CCL2), on survival in patients with NSCLC treated with curative-intent thoracic radiotherapy. Methods: Seventy-five patients with NSCLC treated with curative-intent thoracic radiotherapy were included. Baseline and post-radiotherapy lymphocyte counts, serum IL-6, and CCL2 levels were assessed. Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were analyzed. Results: At baseline, patients with NSCLC exhibited significantly elevated serum IL-6 and CCL2 levels compared to those of healthy controls (p < 0.05). Thoracic radiotherapy significantly decreased lymphocyte counts (p < 0.001). Severe lymphopenia and elevated post-treatment IL-6 and CCL2 levels correlated with shorter OS and PFS (p < 0.05). Patients with the three prognostic factors—severe lymphopenia and elevated post-treatment IL-6 and CCL2 levels—exhibited the poorest outcomes, with an estimated mean PFS of 13.5 months and OS of 29.7 months. Notably, these biomarkers demonstrated greater prognostic value in the advanced-stage subgroup. Moreover, bioinformatics analysis revealed that elevated CCL2 expression was associated with poorer clinical outcomes, an immunogenic tumor microenvironment, and upregulation of immune-related pathways, making it a potential biomarker for prognosis and treatment. Conclusion: Post-treatment lymphopenia and elevated serum IL-6 and CCL2 are significant prognostic markers in patients with NSCLC undergoing thoracic radiotherapy. Immunologic evaluation may guide adjuvant treatment strategies in NSCLC treated with radiotherapy.
Subjects
CCL2
Interleukin-6
Lung cancer
Lymphopenia
Survival outcomes
Publisher
Elsevier B.V.
Type
journal article