Dosimetric predictors of acute hematologic toxicity in cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy

Mell, Loren K.; Kochanski, J.D.; Roeske, John C.; Haslam, Josh J.; Mehta, Neil; Yamada, S. Diane; Hurteau, Jean; Collins, Yvonne; Lengyel, Ernst; Mundt, Arno J.

doi:10.1016/j.ijrobp.2006.03.018

Cited by 273 publications

(322 citation statements)

References 38 publications

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“…2,4,5 Furthermore, myelotoxicity has been identified as a significant poor prognostic factor in patients with T4 EC treated with CRT followed by curative resection. 6 Pelvic radiotherapy and chemotherapy are known to be myelosuppressive in patients with cervical and anal cancers, [7][8][9][10][11][12][13] and radiation oncologists have implemented efforts to mitigate the degree of haematological toxicity (HT) associated with these treatments. Given that the thorax contains approximately 35% of the functional BM, 14 irradiation of these thoracic structures could destroy radiosensitive BM stem cells and contribute to HT in patients with EC.…”

Section: Introductionmentioning

confidence: 99%

“…V x indicates the total organ volume percentage exceeding a radiation dose of x (Gy). Results: Greater thoracic vertebrae and rib irradiation doses, including mean vertebral dose (MVD), thoracic vertebrae V 5-30 (TVV ), mean rib dose and rib V [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] , were associated with increased leukopenia (grade $ 3) risk. Additional BM sites (sternum, scapulae and clavicles) did not influence HT.…”

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confidence: 99%

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Dosimetric predictors of acute haematological toxicity in oesophageal cancer patients treated with neoadjuvant chemoradiotherapy

Lee¹,

Lin²,

Sun³

et al. 2016

BJR

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Objective: Haematological toxicity (HT) is common in patients with oesophageal cancer (EC) treated with chemoradiotherapy (CRT). The Quantitative Analysis of Normal Tissue Effects in the Clinic guidelines provide no dose constraints for the bone marrow (BM) to avoid HT. We aimed to determine dosimetric factors associated with HT during CRT for EC. Methods: 41 patients with EC treated with neoadjuvant cisplatin and 5-fluorouracil-based CRT were retrospectively reviewed. Associations between the dose-volume histogram parameters of thoracic bones and blood cell count changes during CRT were assessed using logistic regression analyses. Receiver-operating characteristic curves were used to derive optimal dosimetric planning constraints. V x indicates the total organ volume percentage exceeding a radiation dose of x (Gy). Results: Greater thoracic vertebrae and rib irradiation doses, including mean vertebral dose (MVD), thoracic vertebrae V 5-30 (TVV 5-30 ), mean rib dose and rib V 5-20 , were associated with increased leukopenia (grade $ 3) risk. Additional BM sites (sternum, scapulae and clavicles) did not influence HT. White blood cell and absolute neutrophil count nadirs were associated with increased irradiation doses to the thoracic vertebrae, ribs and sternum. Chemotherapy cycle number was not significantly associated with severe neutropenia or leukopenia. Cut-off values with the highest likelihood of avoiding leukopenia were MVD , 25.9 Gy, TVV 20 , 70% and TVV 10 , 77%. Conclusion: Thoracic bone irradiation dose was significantly associated with HT after adjusting for chemotherapy effects. Efforts to maintain MVD , 25.9 Gy, TVV 10 , 77% and TVV 20 , 70% could reduce HT. Advances in knowledge: This is the first study addressing issues concerning HT in patients with neoadjuvant CRTtreated EC.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Dosimetric predictors of acute haematological toxicity in oesophageal cancer patients treated with neoadjuvant chemoradiotherapy

Lee¹,

Lin²,

Sun³

et al. 2016

BJR

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“…Some of the challenges of IMRT are to identify the areas of bone marrow to be spared and to evaluate the effectiveness of different sparing protocols [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Proton density water fraction as a biomarker of bone marrow cellularity: Validation in ex vivo spine specimens

MacEwan¹,

Glembotski

D’Lima

et al. 2014

Magnetic Resonance Imaging

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The purpose of this study was to evaluate a magnetic resonance imaging (MRI) technique for quantifying the proton density water fraction (PDWF) as a biomarker of bone marrow cellularity. Thirty-six human bone marrow specimens from 18 donors were excised and subjected to different measurements of tissue composition: PDWF quantification using a multiple gradient echo MRI technique, three biochemical assays (triglyceride, total lipid and water content) and a histological assessment of cellularity. Results showed a strong correlation between PDWF and bone marrow cellularity from histology (r = 0.72). A strong correlation was also found between PDWF and the biochemical assay of water content (r = 0.76). These results suggest the PDWF is a predictor of bone marrow cellularity in tissues and can provide a non-invasive assessment of bone marrow changes in clinical patients undergoing radiotherapy.

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“…This will be the case with 30 of 43 cervical cancer patients [17]. According to the research of Mell et al, cisplatin intake of 4 until 6 chemothrapy cycles would trigger acute anemia with the percentage of 48.6% in cervical cancer patients [18]. Another research by Umayahara et al…”

Section: Difference In Blood Function Toxicitymentioning

confidence: 98%

Difference in Blood Function Toxicity Between Stadium Iib-Iiib Squamous Cell Cervical Cancer Patients With Paclitaxel Cisplatin and Paclitaxel Carboplatin Chemotherapy at Sanglah Hospital, Denpasar.

Indrayathi

Noviyani

Niruri

et al. 2018

Asian J Pharm Clin Res

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Objective: Paclitaxel cisplatin and paclitaxel carboplatin were chemotherapy regimens used for cervical cancer treatments at Sanglah Hospital, Denpasar. They came with hematologic toxicity side effects. This could be monitored from hemoglobin, thrombocyte, and leukocyte parameter. Data that compared the toxicity of these two regimens were still limited at Sanglah Hospital, Denpasar. Therefore, it was necessary to conduct a research about the difference in blood function toxicity between patients who underwent paclitaxel cisplatin chemotherapy and those who underwent paclitaxel carboplatin chemotherapy based on those three parameters.Methods: This was a prospective observational research with consecutive sampling, inclusion, and exclusion criteria. It was carried out from January to August 2016 at Sanglah Hospital, Denpasar. Patients were categorized into two groups based on their chemotherapy regimens. Next, blood samples from both groups were tested for its hemoglobin, thrombocyte, and leukocyte level before and after chemotherapy. The data underwent normality test using either Shapiro-Wilk or Mann-Whitney test with SPSS.Results: There were 17 patients who fulfilled the inclusion criteria. The result showed a decrease in hemoglobin, thrombocyte, as well as leukocyte values in patients who underwent paclitaxel cisplatin and paclitaxel carboplatin chemotherapy. Conclusion:The decrease of both hemoglobin and leukocyte level was not meaningful in both groups (p>0.05). Meanwhile, the decrease of thrombocyte level was meaningful in both groups (*p<0.05) in which patients who belong to paclitaxel carboplatin chemotherapy group showed a higher decrease of thrombocyte values.

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Dosimetric predictors of acute hematologic toxicity in cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy

Cited by 273 publications

References 38 publications

Dosimetric predictors of acute haematological toxicity in oesophageal cancer patients treated with neoadjuvant chemoradiotherapy

Dosimetric predictors of acute haematological toxicity in oesophageal cancer patients treated with neoadjuvant chemoradiotherapy

Proton density water fraction as a biomarker of bone marrow cellularity: Validation in ex vivo spine specimens

Difference in Blood Function Toxicity Between Stadium Iib-Iiib Squamous Cell Cervical Cancer Patients With Paclitaxel Cisplatin and Paclitaxel Carboplatin Chemotherapy at Sanglah Hospital, Denpasar.

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