| Huang Sicheng,Wang Gang,Wang Wenling,Dong Hongmin,Chen Weiwei,Li Xiaokai,Chen Wanghua,Li Guodong,Li Leilei,Chen Juan.Relationship between the pelvic bone marrow dose-volume parameters and acute hematologic toxicity in neoadjuvant pelvic intensity-modulated radiotherapy for local advance rectal cancer[J].Chinese Journal of Radiological Medicine and Protection,2023,43(2):94-100 |
| Relationship between the pelvic bone marrow dose-volume parameters and acute hematologic toxicity in neoadjuvant pelvic intensity-modulated radiotherapy for local advance rectal cancer |
| Received:August 22, 2022 |
| DOI：10.3760/cma.j.cn112271-20220822-00339 |
| KeyWords:Rectal cancer Neoadjuvant concurrent chemoradiotherapy Pelvic bone marrow Irradiated bone marrow volume Acute hematological toxicity |
| FundProject:贵州省教育厅创新群体重大研究项目（黔教合KY字[2018]020） |
| Author Name | Affiliation | E-mail | | Huang Sicheng | Oncology Teaching and Research Office, Guizhou Medical University, Guiyang 550004, China | | | Wang Gang | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | 389896586@qq.com | | Wang Wenling | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Dong Hongmin | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Chen Weiwei | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Li Xiaokai | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Chen Wanghua | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Li Guodong | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Li Leilei | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | | | Chen Juan | Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China | |
|
| Hits: 1225 |
| Download times: 388 |
| Abstract:: |
| Objective To analyze the correlation between the volume of irradiated pelvic bone marrow and acute hematologic toxicity (HT), in order to provide clinical data to reduce the risk of acute HT and optimize the radiotherapy plan.Methods From October 2017 to May 2019, 41 LARC patients who received neoadjuvant concurrent chemoradiotherapy (CCRT) were retrospectively reviewed in our center. All patients were treated with 5-field intensity-modulated radiotherapy (IMRT), and the prescription dose delivered to PTV was 45-50.4 Gy in 25-28 fractions. Capecitabine or 5-fluorouracil (5-FU) wasadministered daily 5 days a week during radiotherapy. Different HTswere recorded according to National Cancer Institute Common Toxicity Criteria Version 5.0 (NCI-CTC.V5.0) based on laboratory tests. The volume of PBM or each site (coxal, sacrum, femoral) receiving more than x Gy refers to as TVx, CVx, SVx, and FVx, respectively. Logistic regression was performed to evaluate the association between the volume of irradiated pelvic bone marrow and different HT. Generalized additive model (GAM) and piecewise regression were used to further analyze the possible nonlinear relationship and threshold effect between them.Results Multivariate logistic regression analysis showed that low-dose of irradiated total pelvic bone marrow volume (TV5) and coxal bone marrow volume (CV5, CV10) were significantly correlated with Grade ≥ 2 leukopenia(P<0.05). There was a significant negative correlation between the sacrum bone marrow volume (SV5, SV10) and Grade ≥ 2 leukopenia (P<0.05). A thresholdeffect has been observed between CV10 and Grade ≥ 2 leukopenia by Generalized additive model (GAM) and piecewise linear regression. The threshold between CV10 and Grade ≥ 2 leukopenia was 575 ml, OR (95%CI) was 1.85 (1.08, 3.16). Conclusions In neoadjuvant IMRT of rectal cancer, CV is a better predictor of acute HT induced by CCRT than TV. The irradiated volume of CV associated with acute HT was mainly low-dose levels (CV5, CV10). The thresholds of our study (CV10=575 ml) could be a good reference for the optimization of the radiotherapy plan. |
| HTML View Full Text View/Add Comment Download reader |
| Close |
|
|
|
