# Identifying key risk factors for thrombocytopenia in patients undergoing radical chemoradiotherapy for nasopharyngeal cancer: a retrospective study

## TL;DR

This study identifies smoking and low initial platelet counts as risk factors for reduced platelet levels in nasopharyngeal cancer patients undergoing chemoradiotherapy.

## Contribution

The study reveals smoking and preoperative platelet count as independent risk factors for thrombocytopenia in NPC patients undergoing chemoradiotherapy.

## Key findings

- Smoking is a significant independent risk factor for thrombocytopenia after chemoradiotherapy.
- Lower preoperative platelet counts are associated with increased risk of thrombocytopenia.
- Dynamic monitoring of platelet levels is recommended for smokers and patients with low baseline counts.

## Abstract

In this study, we investigated the risk factors for thrombocytopenia in patients undergoing radical chemoradiotherapy for nasopharyngeal carcinoma (NPC).

We retrospectively analyzed clinical data and laboratory indicators of 318 patients initially diagnosed with NPC who received radical chemoradiotherapy at our institution between January 2013 and May 2024. The patients were stratified into three groups based on the severity of post-chemoradiotherapy thrombocytopenia. Clinical parameters and laboratory indices were then systematically compared among these groups.

Platelet counts before and after chemoradiotherapy differed significantly (Z = −15.421; p < 0.001). No significant differences were observed among the groups in age, sex, hypertension, diabetes, alcohol consumption, or T, N, and M stages (all, p> 0.05). However, smoking status differed significantly (p < 0.001). Logistic regression identified smoking (odds ration [OR] = 3.393; 95% confidence interval [CI], 1.88–6.123; p < 0.001) and preoperative platelet count (OR = 0.993; 95% CI, 0.989–0.997; p < 0.001) as independent risk factors for post-chemoradiotherapy thrombocytopenia.

Smoking and low baseline platelet counts were independent risk factors for thrombocytopenia following radical chemoradiotherapy in patients with NPC. Therefore, dynamic monitoring of platelet levels in smokers and in those with low preoperative counts is crucial throughout treatment.