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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2026-25-4-110-115</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-4417</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОПЫТ РАБОТЫ ОНКОЛОГИЧЕСКИХ УЧРЕЖДЕНИЙ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ONCOLOGY PRACTICE</subject></subj-group></article-categories><title-group><article-title>Влияние лучевой терапии на гематологические клетки у онкологических пациентов в развивающейся стране</article-title><trans-title-group xml:lang="en"><trans-title>Impact of radiation therapy on hematological cells among cancer patients in a developing country</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6238-1705</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Majeed</surname><given-names>Imran</given-names></name><name name-style="western" xml:lang="en"><surname>Majeed</surname><given-names>Imran</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, PhD, врач-консультант по радиационной онкологии, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, PhD, Consultant Physicist, Radiation Oncology, Jinnah Hospital.</p><p>Lahore</p></bio><email xlink:type="simple">bisimran@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Farooq</surname><given-names>Mehreen</given-names></name><name name-style="western" xml:lang="en"><surname>Farooq</surname><given-names>Mehreen</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, MBBS, MCPS, радиационная онкология, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, MBBS, MCPS, Radiation Oncology, Jinnah Hospital.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ali</surname><given-names>Capt Mubashir</given-names></name><name name-style="western" xml:lang="en"><surname>Ali</surname><given-names>Capt Mubashir</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, MBBS DMRT, радиотерапевт, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, MBBS DMRT, Consultant Radiation Oncology, Jinnah Hospital.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Hussain</surname><given-names>Mazhar</given-names></name><name name-style="western" xml:lang="en"><surname>Hussain</surname><given-names>Mazhar</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, MBBS FCPS, радиотерапевт, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, MBBS FCPS, Consultant Radiation Oncologist, Jinnah Hospital.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Zeb</surname><given-names>Maryam</given-names></name><name name-style="western" xml:lang="en"><surname>Zeb</surname><given-names>Maryam</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, MBBS, отделение лучевой терапии, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, MBBS, Radiation Oncology, Jinnah Hospital.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Nazir</surname><given-names>Abeeha</given-names></name><name name-style="western" xml:lang="en"><surname>Nazir</surname><given-names>Abeeha</given-names></name></name-alternatives><bio xml:lang="ru"><p>MPhil, Лахорский технологический университет.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MPhil, University of Engineering and Technology.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Amjad</surname><given-names>Fatima</given-names></name><name name-style="western" xml:lang="en"><surname>Amjad</surname><given-names>Fatima</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, MBBS, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, MBBS, Jinnah Hospital.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Hameed</surname><given-names>Kashif</given-names></name><name name-style="western" xml:lang="en"><surname>Hameed</surname><given-names>Kashif</given-names></name></name-alternatives><bio xml:lang="ru"><p>MD, MBBS, Отделение лучевой терапии, Больница Джинна.</p><p>Лахор</p></bio><bio xml:lang="en"><p>MD, MBBS, Radiation Oncology, Jinnah Hospital.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Больница Джинна</institution><country>Пакистан</country></aff><aff xml:lang="en"><institution>Jinnah Hospital</institution><country>Pakistan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>21</day><month>09</month><year>2026</year></pub-date><volume>25</volume><issue>4</issue><fpage>110</fpage><lpage>115</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Majeed I., Farooq M., Ali C.M., Hussain M., Zeb M., Nazir A., Amjad F., Hameed K., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Majeed I., Farooq M., Ali C.M., Hussain M., Zeb M., Nazir A., Amjad F., Hameed K.</copyright-holder><copyright-holder xml:lang="en">Majeed I., Farooq M., Ali C.M., Hussain M., Zeb M., Nazir A., Amjad F., Hameed K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/4417">https://www.siboncoj.ru/jour/article/view/4417</self-uri><abstract><p>Введение. Иммунная система – сложная сеть органов, клеток и белков. Здоровая иммунная система способна распознать и уничтожить болезнетворные микроорганизмы (или патогены), а также раковые клетки, защищая при этом здоровые ткани. Лейкоциты являются ключевым звеном иммунной системы. Цель исследования – оценка влияния лучевой терапии на иммунную систему. Материал и методы. Данные 106 онкологических пациентов были собраны в отделении радиационной онкологии больницы Джинна в Лахоре, Пакистан, в период с января 2018 г. по сентябрь 2022 г. У пациентов проводился общий анализ крови до и после терапии. Результаты. Среди пациентов было 54,2 % женщин и 45,7 % мужчин в возрасте от 29 до 80 лет. У 64 % пациентов наблюдалось снижение количества тромбоцитов, у 71,4 % – снижение уровня гемоглобина, у 68,5 % – снижение общего количества лейкоцитов после лучевой терапии. Заключение. На основании анализа полученных данных установлено, что лучевая терапия влияет на иммунную систему пациентов. У большинства пациентов после лечения наблюдалось снижение уровня гемоглобина, количества лейкоцитов и тромбоцитов.</p></abstract><trans-abstract xml:lang="en"><p>Background. Immune system is made up of different organs, cells and proteins. a healthy immune system can defeat invading disease-causing germs (or pathogens), such as bacteria, viruses, parasites as well as cancer cells while protecting healthy tissue. White blood cells are the key players in the hematological immune system. Objective. The aim of this research is to detect the radiation therapy effect on the immune system. Material and Methods. Data of 106 cancer patients have been collected from Department of Radiation Oncology, Jinnah Hospital Lahore, Pakistan since January 2018 to September 2022 and compete blood count of these patients is seen regularly before and after therapy. Results. There were 54.2 % female and 45.7 % male patients in the age range of 29–80 years. The 64 % patients were observed with decrease in platelets count, 71.4 % cancer patients had shown a reduction in hemoglobin level and 68.5 % of patients indicated a decline in TLC after the radiation therapy. Conclusion. Conclusions have been drawn from analyzing the data in this research work. Radiation therapy affects the immune system of the patients. Majority of patients have low White Blood Cells Counts after the treatment and also showed low Hemoglobin and Platelets Count.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>лучевая терапия</kwd><kwd>гематологические нарушения</kwd><kwd>иммунная система</kwd><kwd>воспаление</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ionizing radiation</kwd><kwd>hematological immune system</kwd><kwd>inflammation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Vaiserman A., Koliada A., Zabuga O., Socol Y. Health Impacts of Low-Dose Ionizing Radiation: Current Scientific Debates and Regulatory Issues. Dose Response. 2018; 16(3): 1559325818796331. doi: 10.1177/1559325818796331.</mixed-citation><mixed-citation xml:lang="en">Vaiserman A., Koliada A., Zabuga O., Socol Y. Health Impacts of Low-Dose Ionizing Radiation: Current Scientific Debates and Regulatory Issues. Dose Response. 2018; 16(3): 1559325818796331. doi: 10.1177/1559325818796331.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Brundha M.P., Pathmashri V.P., Sundari S. Quantitative changes of red blood cells in cancer patients under palliative radiotherapy – A retrospective study. Res J Pharm Technol. 2019; 12(2): 687–92. doi: 10.5958/0974-360X.2019.00122.7.</mixed-citation><mixed-citation xml:lang="en">Brundha M.P., Pathmashri V.P., Sundari S. Quantitative changes of red blood cells in cancer patients under palliative radiotherapy – A retrospective study. Res J Pharm Technol. 2019; 12(2): 687–92. doi: 10.5958/0974-360X.2019.00122.7.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Chen H.H.W., Kuo M.T. Improving radiotherapy in cancer treatment: Promises and challenges. Oncotarget. 2017; 8(37): 62742–58. doi: 10.18632/oncotarget.18409.</mixed-citation><mixed-citation xml:lang="en">Chen H.H.W., Kuo M.T. Improving radiotherapy in cancer treatment: Promises and challenges. Oncotarget. 2017; 8(37): 62742–58. doi: 10.18632/oncotarget.18409.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">De Ruysscher D., Niedermann G., Burnet N.G., Siva S., Lee A.W.M., Hegi-Johnson F. Radiotherapy toxicity. Nat Rev Dis Primers. 2019; 5(1): 13. doi: 10.1038/s41572-019-0064-5. Erratum in: Nat Rev Dis Primers. 2019; 5(1): 15. doi: 10.1038/s41572-019-0073-4.</mixed-citation><mixed-citation xml:lang="en">De Ruysscher D., Niedermann G., Burnet N.G., Siva S., Lee A.W.M., Hegi-Johnson F. Radiotherapy toxicity. Nat Rev Dis Primers. 2019; 5(1): 13. doi: 10.1038/s41572-019-0064-5. Erratum in: Nat Rev Dis Primers. 2019; 5(1): 15. doi: 10.1038/s41572-019-0073-4.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Alet A.I., Porini S., Riquelme B.D., Bisio A., Scifoni E., Galassi M.E. Effects of ionizing radiations of different qualities and delivery types on blood cells. Biophys Rev. 2025; 17(2): 579–90. doi: 10.1007/s12551-025-01302-0.</mixed-citation><mixed-citation xml:lang="en">Alet A.I., Porini S., Riquelme B.D., Bisio A., Scifoni E., Galassi M.E. Effects of ionizing radiations of different qualities and delivery types on blood cells. Biophys Rev. 2025; 17(2): 579–90. doi: 10.1007/s12551-025-01302-0.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Jameus A., Kennedy A.E., Thome C. Hematological Changes Following Low Dose Radiation Therapy and Comparison to Current Standard of Care Cancer Treatments. Dose Response. 2021; 19(4): 15593258211056196. doi: 10.1177/15593258211056196.</mixed-citation><mixed-citation xml:lang="en">Jameus A., Kennedy A.E., Thome C. Hematological Changes Following Low Dose Radiation Therapy and Comparison to Current Standard of Care Cancer Treatments. Dose Response. 2021; 19(4): 15593258211056196. doi: 10.1177/15593258211056196.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">El-Dessouky Y.M., El-Dessouky M.M., El-Batrawy O.A. Penicillamine as radiation protector against gamma radiation effect on complete blood count parameters of guinea pigs.AlAzharAssiut Med J. 2019; 17(2): 145–53. doi: 10.4103/AZMJ.AZMJ_137_18.</mixed-citation><mixed-citation xml:lang="en">El-Dessouky Y.M., El-Dessouky M.M., El-Batrawy O.A. Penicillamine as radiation protector against gamma radiation effect on complete blood count parameters of guinea pigs.AlAzharAssiut Med J. 2019; 17(2): 145–53. doi: 10.4103/AZMJ.AZMJ_137_18.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Wisdom A.J., Barker C.A., Chang J.Y., Demaria S., Formenti S., Grassberger C., Gregucci F., Hoppe B.S., Kirsch D.G., Marciscano A.E., Mayadev J., Mouw K.W., Palta M., Wu C.C., Jabbour S.K., Schoenfeld J.D. The Next Chapter in Immunotherapy and Radiation Combination Therapy: Cancer-Specific Perspectives. Int J Radiat Oncol Biol Phys. 2024; 118(5): 1404–21. doi: 10.1016/j.ijrobp.2023.12.046.</mixed-citation><mixed-citation xml:lang="en">Wisdom A.J., Barker C.A., Chang J.Y., Demaria S., Formenti S., Grassberger C., Gregucci F., Hoppe B.S., Kirsch D.G., Marciscano A.E., Mayadev J., Mouw K.W., Palta M., Wu C.C., Jabbour S.K., Schoenfeld J.D. The Next Chapter in Immunotherapy and Radiation Combination Therapy: Cancer-Specific Perspectives. Int J Radiat Oncol Biol Phys. 2024; 118(5): 1404–21. doi: 10.1016/j.ijrobp.2023.12.046.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Abdul-Latif M., Conibear J., Thiruthaneeswaran N., Tsang Y.M. Does radiation-induced lymphocytopenia matter? Developing a radiotherapy dosimetric strategy for immune preservation and improved survival. BMJ Oncol. 2025; 4(1): e000745. doi: 10.1136/bmjonc-2025-000745.</mixed-citation><mixed-citation xml:lang="en">Abdul-Latif M., Conibear J., Thiruthaneeswaran N., Tsang Y.M. Does radiation-induced lymphocytopenia matter? Developing a radiotherapy dosimetric strategy for immune preservation and improved survival. BMJ Oncol. 2025; 4(1): e000745. doi: 10.1136/bmjonc-2025-000745.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Chow J.C.H., Ho J.C.S., Cheung K.M., Johnson D., Ip B.Y.M., Beitler J.J., Strojan P., Mäkitie A.A., Eisbruch A., Ng S.P., Nuyts S., Mendenhall W.M., Babighian S., Ferlito A. Neurological complications of modern radiotherapy for head and neck cancer. Radiother Oncol. 2024; 194: 110200. doi: 10.1016/j.radonc.2024.110200.</mixed-citation><mixed-citation xml:lang="en">Chow J.C.H., Ho J.C.S., Cheung K.M., Johnson D., Ip B.Y.M., Beitler J.J., Strojan P., Mäkitie A.A., Eisbruch A., Ng S.P., Nuyts S., Mendenhall W.M., Babighian S., Ferlito A. Neurological complications of modern radiotherapy for head and neck cancer. Radiother Oncol. 2024; 194: 110200. doi: 10.1016/j.radonc.2024.110200.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Jelonek K., Pietrowska M., Widlak P. Systemic effects of ion- izing radiation at the proteome and metabolome levels in the blood of cancer patients treated with radiotherapy: the influence of inflamma- tion and radiation toxicity. Int J Radiat Biol. 2017; 93(7): 683–96. doi: 10.1080/09553002.2017.1304590.</mixed-citation><mixed-citation xml:lang="en">Jelonek K., Pietrowska M., Widlak P. Systemic effects of ion- izing radiation at the proteome and metabolome levels in the blood of cancer patients treated with radiotherapy: the influence of inflamma- tion and radiation toxicity. Int J Radiat Biol. 2017; 93(7): 683–96. doi: 10.1080/09553002.2017.1304590.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Swanson G.P., Hammonds K., Jhavar S. Reference Results for Blood Parameter Changes and Recovery after Pelvic Radiation without Chemotherapy. Hematol Rep. 2022; 14(2): 155–64. doi: 10.3390/hematolrep14020023.</mixed-citation><mixed-citation xml:lang="en">Swanson G.P., Hammonds K., Jhavar S. Reference Results for Blood Parameter Changes and Recovery after Pelvic Radiation without Chemotherapy. Hematol Rep. 2022; 14(2): 155–64. doi: 10.3390/hematolrep14020023.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Wersal C., Keller A., Weiss C., Giordano F.A., Abo-Madyan Y., Tuschy B., Sütterlin M., Wenz F., Sperk E. Long-term changes in blood counts after intraoperative radiotherapy for breast cancer-single center experience and review of the literature. Transl Cancer Res. 2019; 8(5): 1882–903. doi: 10.21037/tcr.2019.09.05.</mixed-citation><mixed-citation xml:lang="en">Wersal C., Keller A., Weiss C., Giordano F.A., Abo-Madyan Y., Tuschy B., Sütterlin M., Wenz F., Sperk E. Long-term changes in blood counts after intraoperative radiotherapy for breast cancer-single center experience and review of the literature. Transl Cancer Res. 2019; 8(5): 1882–903. doi: 10.21037/tcr.2019.09.05.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Joseph N., Cicchetti A., McWilliam A., Webb A., Seibold P., Fiorino C., Cozzarini C., Veldeman L., Bultijnck R., Fonteyne V., Talbot C.J., Symonds P.R., Johnson K., Rattay T., Lambrecht M., Haustermans K., De Meerleer G., Elliott R.M., Sperk E., Herskind C., Veldwijk M., Avuzzi B., Giandini T., Valdagni R., Azria D., Jacquet M.F., Charissoux M., Vega A., Aguado-Barrera M.E., Gómez-Caamaño A., Franco P., Garibaldi E., Girelli G., Iotti C., Vavassori V., Chang-Claude J., West C.M.L., Rancati T., Choudhury A. High weekly integral dose and larger fraction size increase risk of fatigue and worsening of functional outcomes following radiotherapy for localized prostate cancer. Front Oncol. 2022; 12: 937934. doi: 10.3389/fonc.2022.937934.</mixed-citation><mixed-citation xml:lang="en">Joseph N., Cicchetti A., McWilliam A., Webb A., Seibold P., Fiorino C., Cozzarini C., Veldeman L., Bultijnck R., Fonteyne V., Talbot C.J., Symonds P.R., Johnson K., Rattay T., Lambrecht M., Haustermans K., De Meerleer G., Elliott R.M., Sperk E., Herskind C., Veldwijk M., Avuzzi B., Giandini T., Valdagni R., Azria D., Jacquet M.F., Charissoux M., Vega A., Aguado-Barrera M.E., Gómez-Caamaño A., Franco P., Garibaldi E., Girelli G., Iotti C., Vavassori V., Chang-Claude J., West C.M.L., Rancati T., Choudhury A. High weekly integral dose and larger fraction size increase risk of fatigue and worsening of functional outcomes following radiotherapy for localized prostate cancer. Front Oncol. 2022; 12: 937934. doi: 10.3389/fonc.2022.937934.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Yang Y., Hou X., Kong S., Zha Z., Huang M., Li C., Li N., Ge F., Chen W. Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review). Mol Med Rep. 2023; 28(6): 231. doi: 10.3892/mmr.2023.13118.</mixed-citation><mixed-citation xml:lang="en">Yang Y., Hou X., Kong S., Zha Z., Huang M., Li C., Li N., Ge F., Chen W. Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review). Mol Med Rep. 2023; 28(6): 231. doi: 10.3892/mmr.2023.13118.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Joseph N., Alagiyawanna L., Ruwanpura T., Gunasekera S., Ruvinda L., Madushan S., Choudhury A. Whole-body integral dose and post-radiotherapy lymphocytopaenia in solid tumours. BMJ Oncol. 2025; 4(1): e000522. doi: 10.1136/bmjonc-2024-000522.</mixed-citation><mixed-citation xml:lang="en">Joseph N., Alagiyawanna L., Ruwanpura T., Gunasekera S., Ruvinda L., Madushan S., Choudhury A. Whole-body integral dose and post-radiotherapy lymphocytopaenia in solid tumours. BMJ Oncol. 2025; 4(1): e000522. doi: 10.1136/bmjonc-2024-000522.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Terrones-Campos C., Ledergerber B., Vogelius I.R., Helleberg M., Specht L., Lundgren J. Hematological toxicity in patients with solid malignant tumors treated with radiation – Temporal analysis, dose response and impact on survival. Radiother Oncol. 2021; 158: 175–83. doi: 10.1016/j.radonc.2021.02.029.</mixed-citation><mixed-citation xml:lang="en">Terrones-Campos C., Ledergerber B., Vogelius I.R., Helleberg M., Specht L., Lundgren J. Hematological toxicity in patients with solid malignant tumors treated with radiation – Temporal analysis, dose response and impact on survival. Radiother Oncol. 2021; 158: 175–83. doi: 10.1016/j.radonc.2021.02.029.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
