scholarly journals Effects of irradiation doses <10 Gy and irradiated bone volume on the change in blood counts during and after pelvic irradiation

2021 ◽  
Vol 8 (2) ◽  
pp. 145
Author(s):  
Laure Kuntz ◽  
Audrey Keller ◽  
Clara Le Fèvre ◽  
Inès Menoux ◽  
Gianandrea Pietta ◽  
...  
Keyword(s):  
At Risk ◽  
Bone Marrow ◽  
Organs At Risk ◽  
Conformal Radiotherapy ◽  
Tumor Location ◽  
Primary Objective ◽  
Trial Registration ◽  
Pelvic Bone ◽  
Hematological Toxicity ◽  
Pelvic Irradiation

<p class="abstract"><strong>Background:</strong> Bone marrow is one of the organs at risk of complications during irradiation due to its radiosensitivity. Hematopoietic toxicity remains one of the main toxicities during irradiation of pelvis. Modern radiotherapy techniques, such as intensity modulation and three-dimensional conformal radiotherapy, allow for better dose compliance in target volumes while optimally sparing organs at risk. There is a lack of prospective studies and comparative trials specifying the dose constraints according to the presence or absence of chemotherapy and correlating with the patient’s bone marrow potential.</p><p class="abstract"><strong>Methods:</strong> This monocentric and prospective study conducted by the Strasbourg Europe Cancerology Institute aims to evaluate the hematological toxicity in patients treated with pelvic irradiation for prostate, rectum, anal canal, endometrium, or cervix cancer. One hundred patients will be included. The primary objective is to quantify the relationship between acute hematological toxicity and delivered doses and irradiated volumes in pelvic bone marrow for pelvic cancers. The prescribed dose to the pelvis depends on the tumor location, from 25 Gy in 5 fractions for rectal cancer to 78 Gy in 39 fractions for low-risk prostate cancer. Hematological toxicity will be measured by weekly blood count during radiotherapy and at one month and three months after the end of radiotherapy.</p><p class="abstract"><strong>Conclusions: </strong>The aim of this study is to improve and optimize radiotherapy if a dose limit or volume constraint is imposed by the results of the study. To our knowledge, this is the first study including several types of pelvic cancers and involving patients treated exclusively with radiotherapy, chemoradiotherapy or radiohormonotherapy.</p><p><strong>Trial Registration:</strong> Trial registration number is NCT04626466.</p>

scholarly journals Correlation of Hematological Toxicity with the Bone Marrow Radiation Dose and Volume during Concurrent Chemo Radiation in Patients with Cervical Cancer

2021 ◽  
Vol 6 (4) ◽  
pp. 407-415
Author(s):  
Ragavendra D Sagar ◽  
Irappa Madabhavi ◽  
Swaroop Revannasiddaiah
Keyword(s):  
Cervical Cancer ◽  
Bone Marrow ◽  
Organs At Risk ◽  
Locally Advanced ◽  
Concurrent Chemotherapy ◽  
Pelvic Bone ◽  
Hematological Toxicity ◽  
Grade Ii ◽  
Planning Ct ◽  
Toxicity Criteria

Aims & Objective: Hematological toxicity is common in patients with cervical cancer treated with concurrent chemo radiotherapy (CT-RT), so the purpose is to assess this hematological toxicity and correlate the toxicity with the dose and volume of bone marrow included in the field of radiation. Materials & Methods: Twenty five patients with histologically proven cervical cancer attending to our Cancer centre from July 2018-August 2019 were the subjects of this study. Patients were treated on 6 MV linear accelerator with a radical intent with concurrent chemotherapy using cisplatin 50 mg weekly. The planning CT was done for all the patients before the treatment and contouring of the pelvic bone marrow apart from other organs at risk was done. Hematological toxicity was assessed using RTOG common toxicity criteria weekly during and at 2 weeks after the completion of the treatment. Results: A total of 25 patients on CT-RT treatment were assessed. Sixteen patients were in locally advanced stage. The variation in HB, TLC, Platelets, and ANC counts from the baseline to 2 weeks after chemo radiotherapy were assessed. Grade II anemia was observed in 12 and Grade III in 2 patients. There were no toxicity as far as WBC and platelets were considered. There was also no correlation between the volume of bone marrow included in the field of irradiation and appearance of anemia. Conclusion: CT-RT for cervical cancer is safe and is associated with minimal hematological toxicity in the form of anemia. The toxicity is same for different volumes of bone marrow included in the field of irradiation with both 3DCRT as well as IMRT technique. The toxicity observed is probably contributed by Cisplatin.

scholarly journals Evolution of treatment planning and dose delivery methods during radiotherapy for patients undergoing bone marrow transplantation: a review

Nukleonika ◽  
2020 ◽  
Vol 65 (1) ◽  
pp. 19-30 ◽  
Author(s):  
Joanna Litoborska ◽  
Tomasz Piotrowski ◽  
Agata Jodda ◽  
Julian Malicki
Keyword(s):  
At Risk ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Treatment Planning ◽  
Marrow Transplantation ◽  
Organs At Risk ◽  
Dose Delivery ◽  
Clinical Value ◽  
Delivery Methods ◽  
Verification Methods

AbstractBackground and objectives: This study describes the treatment planning and dose delivery methods of radiotherapy for patients undergoing bone marrow transplantation. The analysis was carried out in the context of the evolution of these methods over the last 60 years.Materials and methods: A systematic literature search was carried out using the PubMed search engine. Overall, 90 relevant studies were included: 24 general studies, 10 describing isotopes usage, 24 related to conventional and 32 to advanced methods.Results: The analysis of the evolution of radiotherapy methods shows how significantly the precision of dose planning methods and its delivery have changed. The atypical positioning caused by geometrical requirements for applications of isotopes or conventional techniques has been replaced by positioning on a therapeutic couch, which allows a more precise setup of the patient that is necessary for an exact delivery of the planned dose. The dose can be fully optimized and calculated on tomographic images by algorithms implemented in planning systems. Optimization process allows to reduce doses in organs at risk. The accuracy between planned and delivered doses can be checked by pretreatment verification methods, and the patient positioning can be checked by image guidance procedures.Interpretation and conclusions: Current radiotherapy solutions allow a precise delivery of doses to the planning target volume while reducing doses to organs at risk. Nevertheless, it should be kept in mind that establishing radiotherapy as an important element of the whole therapeutic regimen resulted from the follow-up of patients treated by conventional techniques. To confirm the clinical value of new advanced techniques, clinical trials are required.

scholarly journals RADT-45. EFFECT OF DIFFERENT RADIOTHERAPY TECHNIQUES ON HEMATOLOGICAL TOXICITY OF CRANIOSPINAL IRRADIATION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii191-ii191
Author(s):  
Yangqiong Zhang ◽  
Huajun Yang ◽  
Guanhua Deng ◽  
Rishun Luo ◽  
Ping Zhang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
White Blood Cells ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Bone Marrow Suppression ◽  
Craniospinal Irradiation ◽  
Hematological Toxicity ◽  
Control Group ◽  
Observation Group ◽  
Radiotherapy Techniques

Abstract OBJECTIVE To investigate the effect of different radiotherapy techniques on hematological toxicity of craniospinal irradiation. METHODS A retrospective study involving changes in hematology during craniospinal irradiation were conducted. 79 patients were divided into observation group and control group. 36 patients in observation group received intensity modulated radiation therapy and 43 patients in control group received three-dimensional conformal radiotherapy. The prescribed dose of PTV in the two groups are 28.8-36 Gy, and the single dose are 1.6-2.0 Gy. The hematological toxicity changes and bone marrow suppression stage of the two groups of patients before, during and after radiotherapy were recorded and analyzed. RESULTS 90% of patients showed different bone marrow suppression stage during and after radiotherapy. During radiotherapy, the toxicity of hemoglobin in the observation group was more serious than that in the control group (z=-2.272, p=0.023). After radiotherapy, the toxicity of hemoglobin and white blood cells in the observation group was more serious than that in the control group (z=-3.053, p=0.002; z=-3.163, p=0.002). CONCLUSION We should closely observe the changes of hematological toxicity for craniospinal irradiation patient treated with IMRT and take corresponding preventive measures to avoid serious bone marrow suppression stage.

Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer: A Comparison of 3DCRT, IMRT, and RapidARC

2016 ◽  
Vol 26 (4) ◽  
pp. 770-776 ◽  
Author(s):  
Yu Chang ◽  
Zhi-Yong Yang ◽  
Gui-Ling Li ◽  
Qin Li ◽  
Qin Yang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Bone Marrow ◽  
Cancer Patients ◽  
Normal Tissue ◽  
Probability Model ◽  
Normal Tissue Complication Probability ◽  
Pelvic Bone ◽  
Hematological Toxicity ◽  
Probability Models ◽  
Mean Values

ObjectiveTo comparatively evaluate the hematological toxicity (HT) associated with 3 concurrent chemoradiotherapies that are routinely used to treat cervical cancer, including 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiation therapy (IMRT), and RapidARC and to establish a new normal tissue complication probability model of bone marrow (BM) to predict HT in cervical cancer patients undergoing concurrent chemoradiotherapy.MethodsPatients with cervical cancer (N = 100) who received concurrent cisplatin and whole-pelvic radiotherapy were enrolled in this study. Dosimetric parameters (including V10, V20, V30, and V40 and mean doses to the pelvic bone) and HT were analyzed.ResultsThe V20, V30, and V40 and mean doses to the BM were lower in the IMRT and RapidARC groups than in the 3DCRT group, and the RapidARC group had higher V10 and V40 and mean values than the IMRT group. The V20, V30, and V40 and the mean dose to the pelvic bone were positively correlated with HT. Generalized linear normal tissue complication probability models of white blood cell (WBC) and absolute neutrophil cell (ANC) nadirs and BM V20 were established as follows: WBC nadir = 3.382 – 4.056 • V20 + 0.295 • baseline of WBC (adjusted R2 = 0.246, F = 15.847) and ANC nadir = 2.438 – 2.780 • V20 + 0.233 • baseline of ANC (adjusted R2 = 0.236, F = 16.282).ConclusionsThis study suggests that IMRT results in milder hematological toxicity than either 3DCRT or RapidARC. Dosimetric parameters were associated with the incidence of HT in cervical cancer patients who received concurrent chemoradiotherapies.

Volumetric modulated arc therapy versus 3D conformal radiotherapy for selected childhood neoplasms

2014 ◽  
Vol 14 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Marzanna Chojnacka ◽  
Anna Zygmuntowicz-Piętka ◽  
Anna Semaniak ◽  
Katarzyna Pędziwiatr ◽  
Ryszard Dąbrowski ◽  
...  
Keyword(s):  
At Risk ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
High Dose ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
Arc Therapy ◽  
Childhood Neoplasms

AbstractAimThe comparative study of the plan quality between volumetric modulated arc therapy (VMAT) and 3D conformal therapy (3DCRT) for the treatment of selected representative childhood neoplasms was performed.Materials and methodsDuring the year 2013, 44 children with neoplasms were irradiated using VMAT. The 3DCRT plans were created retrospectively and compared with the VMAT plans for four tumour locations. The conformity parameters, dose volume histograms for target volume and organs at risk, number of monitor units and time used to deliver the single fraction were evaluated and compared for each plan. Additionally, for patients with brain tumour the comparison of different arcs configuration was made.ResultsVMAT modality presented the superiority over older conformal methods with regard to the improvement in the dose conformity and normal tissue sparing. The noncoplanar arcs arrangement was beneficial in the decrease of high-dose volume and the protection of the organs at risk located oppositely to the target volume.FindingsVMAT could be preferred technique for treating childhood neoplasms, especially when the complex-shaped target volume is localised close to the critical structures. The noncoplanar arcs arrangement could be the method of choice in the reirradiated patients and in these with laterally located brain tumours.

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