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.

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.

Intravoxel incoherent motion MRI assessment of chemoradiation-induced pelvic bone marrow changes in cervical cancer and correlation with hematological toxicity

2017 ◽  
Vol 46 (5) ◽  
pp. 1491-1498 ◽  
Author(s):  
Elaine Yuen Phin Lee ◽  
Jose Angelo Udal Perucho ◽  
Vince Vardhanabhuti ◽  
Jian He ◽  
Steven Wai Kwan Siu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Bone Marrow ◽  
Intravoxel Incoherent Motion ◽  
Pelvic Bone ◽  
Hematological Toxicity ◽  
Motion Mri

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 455 Proton Beam Therapy in Rectal Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Fok ◽  
S Toh ◽  
J E Maducolil ◽  
H Fowler ◽  
R Clifford ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Proton Beam ◽  
Organs At Risk ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Significant Risk ◽  
Proton Beam Therapy ◽  
Recurrent Rectal Cancer ◽  
Pelvic Bone ◽  
Dosimetric Data

Abstract Introduction Radiotherapy for locally advanced rectal cancer is conventionally performed using photon-based radiotherapy (PBR), carrying significant risk of toxicity to organs at risk (OAR). Proton beam therapy (PBT) potentially delivers equivalent dosimetric radiation to the targeted tissue with improved sparing of OAR. We aimed to compare dosimetric irradiation of OAR for PBT versus PBR in patients with rectal cancer and assess any oncological outcomes. Method An extensive electronic literature search was performed from inception till April 2020 and subsequent meta-analysis performed. Results Six articles met the inclusion criteria. Dosimetric data of irradiation delivered to OAR for PBT and PBR were calculated for the same patients. PBT had significantly less irradiated small bowel compared to 3DCRT and IMRT, (MD -16.95, 95% CI [-24.03, -9.88], p &lt; 0.00001) and (MD -6.96, 95% CI [-12.99, -0.94], p = 0.02) respectively. Similar results were observed for bladder and pelvic bone marrow. Two studies reported clinical and oncological results for PBT in recurrent rectal cancer with overall survival reported as 43% and 68%. Conclusions Dosimetric treatment plans have less irradiation of OAR for rectal cancer with PBT compared to PBR. There is a need for further research in PBT and rectal cancer, as promising results have been shown in recurrent rectal cancer.

Effect of bladder distension on doses to organs at risk in Pulsed-Dose-Rate 3D image-guided adaptive brachytherapy for locally advanced cervical cancer

Brachytherapy ◽  
2017 ◽  
Vol 16 (5) ◽  
pp. 976-980 ◽  
Author(s):  
Jean Philippe Nesseler ◽  
Claire Charra-Brunaud ◽  
Julia Salleron ◽  
Jean François Py ◽  
Andres Huertas ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Dose Rate ◽  
Organs At Risk ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
3D Image ◽  
Bladder Distension ◽  
Locally Advanced Cervical Cancer ◽  
Image Guided ◽  
Pulsed Dose Rate
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