Effects of pelvic bone marrow-sparing radiotherapy on hematological toxicity in older patients with cervical cancer
10.12354/j.issn.1000-8179.2024.20241326
- VernacularTitle:保护盆骨骨髓放疗对老年宫颈癌患者血液毒性影响
- Author:
Sun YAO
1
;
You JINQIANG
1
;
Jiang SHENGPENG
1
;
Wang JING
1
;
Wang QI
1
Author Information
1. 天津医科大学肿瘤医院放疗科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市"肿瘤防治"重点实验室 天津市300060
- Publication Type:Journal Article
- Keywords:
intensity-modulated radiation therapy (IMRT);
pelvic bone marrow;
hematologic toxicity (HT);
cervical cancer
- From:
Chinese Journal of Clinical Oncology
2024;51(21):1108-1114
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the effectiveness of pelvic bone marrow (PBM)-sparing intensity-modulated radiation therapy (IMRT) in mit-igating acute hematologic toxicity (HT) in older patients with cervical cancer. Methods:A retrospective analysis of the data from 41 older pa-tients with cervical cancer who underwent postoperative concurrent chemoradiotherapy (CCRT) between January 2015 and December 2016 at Tianjin Medical University Cancer Institute & Hospital was conducted. The patients were grouped into PBM sparing and non-PBM sparing groups. The HT grades,white blood cells,absolute neutrophils,hemoglobin,and nadir platelet count were assessed. In addition,the volumes of PBM with various radiation doses (V10,V20,V30,and V40) were calculated. Regression models with multiple independent predictors were used to examine the association between dosimetric parameters and HT. Results:The PBM sparing group exhibited a significantly lower incidence of HT and RT breaks than the non-PBM-sparing group. Decreased V20 and V40 were significantly correlated with lower rates of grades ≥2 and ≥3 leukopenia,respectively. A partitioning analysis identified a cutoff value of 61％ for V20 of the whole pelvic bone to predict grade ≥2 leukopenia and 33.5％ for V40 to predict grade ≥3 leukopenia. Conclusions:PBM-sparing RT significantly reduced the in-cidence of acute HT and treatment breaks. Increased PBM V20 and V40 were associated with higher rates of grade ≥2 and grade ≥3 leuko-penia,respectively.
