免疫系统在放射治疗 (RT) 疗效中的作用已得到充分证实。我们研究了肿瘤相关和治疗引起的淋巴细胞减少症在鳞状细胞喉癌 RT 或放化疗 (CRT) 结局中的作用。我们回顾性分析了一系列接受根治性或术后 RT/CRT 治疗的 135 例喉癌。定义并检查了六个与淋巴细胞相关的变量：短暂诱导化疗前的淋巴细胞计数 (LC)，ii． RT 前 LC，iii。 RT 后 LC，iv。 v. RT 前中性粒细胞/淋巴细胞比率 (N/L)，v. RT 前单核细胞/淋巴细胞比率 (M/L)，以及 vi. RT 前血小板/淋巴细胞比率 (Pt/L)。RT 和 CRT 导致治疗结束时 LC 显着降低，这在接受根治性意图和颈部放疗的患者中更为突出（中位 LC 最低点 810/ µl 与 1250/μl；p = .0003）。诱导化疗并没有增强放疗的淋巴毒性作用。放疗前 (<1718/μl) 和放疗后 (<720/μl) 的 LC 低于第 33 个百分位数与较差的局部无进展生存期（LRFS；分别为 p = .02 和 p = .08）和疾病显着相关-特定总生存期（OS；分别为 p = .02 和 p = .03）。多变量分析也证实了这一点（LRFS：分别为 p = .006/HR = 2.41 和 p = .08/HR = 1.76；OS：分别为 p = .001/HR = 3.06 和 p = .02/HR = 2.07 ）。 RT 前的高 N/L、M/L 和 Pt/L 比率也具有不祥的预后相关性。肿瘤相关和 RT 诱导的淋巴细胞减少症从局部失败、转移发生率和以下方面定义了 RT 的结果：最后，喉癌患者的疾病特异性生存率。 RT 前淋巴细胞减少症的恢复和 RT 期间外周淋巴细胞的保护成为关键问题，需要治疗干预以最大限度地提高 RT/CRT 对喉癌患者的疗效。

The role of the immune system in the efficacy of radiotherapy (RT) has been well established. We examined the role of neoplasia-related and treatment-induced lymphopenia in the outcome of RT or chemoradiotherapy (CRT) in squamous cell laryngeal cancer.We retrospectively analyzed a series of 135 laryngeal carcinomas treated with radical or postoperative RT/CRT. Six lymphocyte-related variables were defined and examined: i. lymphocyte counts (LCs) before a brief course of induction chemotherapy, ii. pre-RT LCs, iii. post-RT LCs, iv. pre-RT neutrophil/lymphocyte ratio (N/L), v. pre-RT monocyte/lymphocyte ratio (M/L), and vi. pre-RT platelet/lymphocyte ratio (Pt/L).RT and CRT resulted in a significant decrease of LCs at the end of therapy, and this was significantly more prominent in patients treated with radical intent and neck irradiation (median LC nadir 810/μl vs. 1250/μl; p = .0003). Induction chemotherapy did not intensify the lymphotoxic effect of RT. LCs lower than the 33rd percentile before RT (<1718/μl) and after RT (<720/μl) were significantly linked to poor locoregional progression-free survival (LRFS; p = .02 and p = .08, respectively) and disease-specific overall survival (OS; p = .02 and p = .03, respectively). This was also confirmed multivariate analysis (LRFS: p = .006/HR = 2.41 and p = .08/HR = 1.76, respectively; OS: p = .001/HR = 3.06 and p = .02/HR = 2.07, respectively). High pre-RT N/L, M/L, and Pt/L ratios were also of ominous prognostic relevance.Both neoplasia-related and RT-induced lymphopenia define the outcome of RT in terms of locoregional failure, incidence of metastasis, and, finally, disease-specific survival of patients with laryngeal cancer. Restoration of pre-RT lymphopenia and protection of peripheral lymphocytes during RT emerge as critical issues that demand therapeutic interventions to maximize the efficacy of RT/CRT in patients with laryngeal cancer.