The relationship between the radiation dose of pelvic-bone marrow and lymphocytic toxicity in concurrent chemoradiotherapy for cervical cancer

Radiation Oncology

Research

Yan-Lan Chai¹  Li-Ming Xu¹  Chao Qu¹  Yuan-Jie Cao¹  Jing Wang¹  Bao-Zhong Zhang¹  Yang Li¹  Hai-Ling Hou¹  Jiaqi Zhang¹ 

[1] Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, 300060, Tianjin, China;

关键词: Cervical cancer;    Concurrent chemoradiotherapy;    Intensity-modulated radiation therapy (IMRT);    Lymphocytic toxicity;    Dosimetry parameters;   

DOI  :  10.1186/s13014-023-02205-8

 received in 2022-09-22, accepted in 2023-01-12,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveThe purpose of this study is to verify the correlation between medium and low radiation doses of the pelvic-bone marrow and the incidence of lymphocytic toxicity during concurrent chemoradiotherapy for cervical cancer.Materials and methodsThis research included 117 cervical cancer patients, who received concurrent chemoradiotherapy. Radiotherapy included external-beam radiation therapy and brachytherapy. The dosimetry parameters include the Volume receiving 5 Gy (V5), 10 Gy (V10), 20 Gy (V20), 30 Gy (V30), 40 Gy (V40), 50 Gy (V50), and the mean dose (D mean) of the bone marrow. Lymphocytic toxicity was calculated from lowest lymphocytic count after two cycles of concurrent chemotherapy.ResultsDuring concurrent chemoradiotherapy, the incidence of lymphocytic toxicity is 94.88%. The incidence of grade 3–4 toxicity is 68.38%. Multivariate analysis findings show that the dosimetry parameters V5, V10, V20, and V30 are significantly correlated with lymphocytic toxicity. The patients are divided into small-volume subgroups and large-volume subgroups based on the cutoff values. The relative risk of both grade 1–4 and grade 3–4 lymphocytic toxicity is significantly lower in the small-volume subgroups than in the large-volume subgroups (P < 0.05). Kaplan–Meier analysis shows that the incidence of both grade 1–4 and grade 3–4 lymphocytic toxicity of the small-volume subgroups is significantly lower than that of the large-volume subgroups (P < 0.05).ConclusionThere is a significant correlation between a medium and low dose of pelvic-bone-marrow radiation and incidence of lymphocytic toxicity. Reducing the volume of medium and low radiation doses could effectively reduce incidence of lymphocytic toxicity.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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