TY - JOUR
T1 - Immune defects in breast cancer patients after radiotherapy
AU - Standish, Leanna J.
AU - Torkelson, Carolyn
AU - Hamill, Frank A.
AU - Yim, Daesong
AU - Hill-Force, Alicia
AU - Fitzpatrick, Annette
AU - Olsen, Monica
AU - Schildt, Sandi
AU - Sweet, Erin
AU - Wenner, Cynthia A.
AU - Martzen, Mark R.
PY - 2008/6
Y1 - 2008/6
N2 - The purpose of this study was to evaluate the immune status of women with stage I-III breast cancer after receiving external beam radiotherapy (RT). Fourteen stage I-III, estrogen or progesterone receptor-positive or-negative (FER/PR +\-), postsurgical breast cancer patients undergoing a standard course of chemotherapy and radiation were studied. Complete blood counts (CBC) with differential, phagocytic activity, natural killer (NK) cell functional activity, and tumor necrosis factor-α (TNF-α) and interferon-γ cytokine activity were measured immediately before and for the six weeks following the completion of radiation therapy. Fatigue levels after completion of RT were measured using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale. Nonparametric statistical methods (Wilcoxon rank and Spearman correlations) were used to analyze the data. Compared with postchemotherapy, following the completion of RT, these breast cancer patients showed lymphopenia, low functional activity of natural killer lymphocytes, decreased monocyte phagocytic activity, and decreased TNF-α production but no neutropenia, no anemia, and no change in interferon-γ production. Lymphocyte count did not return to normal by the end of the 6-week post-RT observation period. The severity of lymphopenia and low natural killer cell activity was related to RT area but not radiation dose. Patients did not report significant fatigue levels for the 6 weeks after completing RT. Significant decreases in the numbers and functions of cells from both the innate and adaptive immune system were detected following a standard course of radiation therapy for the treatment of breast cancer. Immune deficits in lymphocyte populations and TNF-α production, should they persist, may have consequences for immune response to residual or recurrent malignancy following completion of conventional treatment. The use of adjunctive immune therapies which target these specific defects may be warranted in the post-treatment period.
AB - The purpose of this study was to evaluate the immune status of women with stage I-III breast cancer after receiving external beam radiotherapy (RT). Fourteen stage I-III, estrogen or progesterone receptor-positive or-negative (FER/PR +\-), postsurgical breast cancer patients undergoing a standard course of chemotherapy and radiation were studied. Complete blood counts (CBC) with differential, phagocytic activity, natural killer (NK) cell functional activity, and tumor necrosis factor-α (TNF-α) and interferon-γ cytokine activity were measured immediately before and for the six weeks following the completion of radiation therapy. Fatigue levels after completion of RT were measured using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale. Nonparametric statistical methods (Wilcoxon rank and Spearman correlations) were used to analyze the data. Compared with postchemotherapy, following the completion of RT, these breast cancer patients showed lymphopenia, low functional activity of natural killer lymphocytes, decreased monocyte phagocytic activity, and decreased TNF-α production but no neutropenia, no anemia, and no change in interferon-γ production. Lymphocyte count did not return to normal by the end of the 6-week post-RT observation period. The severity of lymphopenia and low natural killer cell activity was related to RT area but not radiation dose. Patients did not report significant fatigue levels for the 6 weeks after completing RT. Significant decreases in the numbers and functions of cells from both the innate and adaptive immune system were detected following a standard course of radiation therapy for the treatment of breast cancer. Immune deficits in lymphocyte populations and TNF-α production, should they persist, may have consequences for immune response to residual or recurrent malignancy following completion of conventional treatment. The use of adjunctive immune therapies which target these specific defects may be warranted in the post-treatment period.
KW - Breast cancer
KW - Fatigue
KW - Immune defects
KW - Natural killer cell activity
KW - Phagocytic activity
KW - Radiotherapy
KW - Tumor necrosis factor
UR - http://www.scopus.com/inward/record.url?scp=51549103264&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=51549103264&partnerID=8YFLogxK
U2 - 10.2310/7200.2008.0018
DO - 10.2310/7200.2008.0018
M3 - Article
C2 - 19087768
AN - SCOPUS:51549103264
SN - 1715-894X
VL - 6
SP - 110
EP - 121
JO - Journal of the Society for Integrative Oncology
JF - Journal of the Society for Integrative Oncology
IS - 3
ER -
