Hematologic Toxicity Comparison of Intensity Modulated Proton Therapy and Intensity Modulated Radiation Therapy in Anal Cancer Patients.

Autor:	Nelson B; Department of Radiation Oncology, University of Cincinnati., Tadesse DG; Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH., Sudhoff M; Department of Radiation Oncology, University of Cincinnati., Wang K; Department of Radiation Oncology, University of Cincinnati., Meier T; Department of Radiation Oncology, University of Cincinnati., Mascia A; Department of Radiation Oncology, University of Cincinnati., Kharofa J; Department of Radiation Oncology, University of Cincinnati.
Jazyk:	angličtina
Zdroj:	American journal of clinical oncology [Am J Clin Oncol] 2022 Jun 01; Vol. 45 (6), pp. 264-267. Date of Electronic Publication: 2022 May 02.
DOI:	10.1097/COC.0000000000000916
Abstrakt:	Purpose: We hypothesize that hematologic toxicity will be lower in anal cancer patients treated definitively with intensity modulated proton therapy (IMPT) compared with patients treated with intensity modulated radiation therapy (IMRT). Methods: Patients enrolled on a prospective feasibility trial assessing the use of IMPT for anal cancer were compared with contemporaneous patients treated with IMRT. Blood counts were collected during chemoradiation. Hematologic events were graded according to CTCAE version 5.0. Pelvic bone marrow (PBM) and positron emission tomography-defined active bone marrow (ABM) were defined and contoured for each patient. Toxicity rates, PBM and ABM dose metrics were compared between groups. Results: Forty-one patients treated with definitive chemoradiation for anal cancer between 2015 and 2021 were included in this analysis. Of the evaluable patients, 14 patients were treated with IMPT and 27 were treated with IMRT. All PBM dose metrics were lower in patients receiving IMPT. Patients treated with IMPT versus IMRT also had a significantly lower ABM mean dose (1996 vs. 3073 Gy, P<0.01). However, there was no statistically significant difference in hematologic toxicity between the groups. Seventy percent of patients treated with IMRT had at least 1 grade ≥3 hematologic event compared with 86% in the IMPT group (P=0.48). Conclusion: Proton treatment reduced bone marrow doses but was not associated with lower hematologic toxicity when compared with IMRT. Competing Interests: J.K. is a Scientific Advisor for Vulcan Biologics. The remaining authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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