Treatment of symptomatic splenomegaly with low doses of radiotherapy: Retrospective analysis and review of the literature
| Autor: | Eva Fernández Lizarbe, Jose Antonio Dominguez Rullán, Ángel Montero Luis, Sonsoles Sancho García, Carolina de la Pinta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty Cirrhosis medicine.medical_treatment lcsh:R895-920 Spleen Neutropenia lcsh:RC254-282 Case reports and case series 03 medical and health sciences 0302 clinical medicine Ectasia medicine Radiology Nuclear Medicine and imaging Care Planning Low doses Radiotherapy Oncology (nursing) business.industry Health Policy Myeloid leukemia Adaptative medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Lymphoma Extramedullary hematopoiesis Radiation therapy medicine.anatomical_structure 030220 oncology & carcinogenesis Splenomegaly 030211 gastroenterology & hepatology Radiology business |
| Zdroj: | Technical Innovations & Patient Support in Radiation Oncology, Vol 3, Iss C, Pp 23-29 (2017) Technical Innovations & Patient Support in Radiation Oncology |
| ISSN: | 2405-6324 |
| Popis: | Highlights • Low doses radiation therapy in splenomegaly. • Technical management of spleen irradiation. • Toxicities in spleen irradiation. Objectives To evaluate the effectiveness of low doses of radiation therapy for symptomatic splenomegaly in malignant and benign diseases. Patients and methods 5 patients with symptomatic splenomegaly were treated with low doses of radiation in our centre (January 2008–December 2016). 4/5 patients had malignant neoplasia (acute myeloid leukemia, non Hogdkin lymphoma and prolymphocytic B cell leukemia) and splenomegaly was caused by extramedullary hematopoiesis. 1/5 patient had benign disease (HBV liver cirrhosis) and splenomegaly was caused by vascular ectasia. Median age was 73 years (range 61–86 years). There were 4 females and 1 male. These patients had exclusively splenic pain or abdominal discomfort in 20%, exclusively cytopenias 40% and both 40%. Patients needed radiation therapy for symptomatic control. Dose per fraction was 0.5 Gy every two days; total dose initially prescribed 10 Gy. IGRT were performed in all patients to ensure an appropriate position and to adapt the treatment volume to the changes in the spleen volume along the treatment. Median craneocaudal length size of the spleen was more than 26 cm (range 15.2–34.9 cm). Results Median radiation doses were 4.85 Gy (range 2.5–10). Median craneocaudal spleen size reduction was 4.6 cm (0–8 cm). Splenic pain and abdominal disturbances improved in all patients. Median increase of haemoglobin and platelets levels was 1.6 mg/dl and 27.950 cells respectively in the first week after the end of radiotherapy. One patient had to interrupt her treatment due to grade II neutropenia. No other toxicities were described. With a median follow-up of 39 months (16–89 months), only one recurrence was described at 24 months and consisted of thrombocytopenia. The patient received a second course of radiotherapy with excellent response. Conclusion Low doses of radiation therapy for treatment of symptomatic splenomegaly were effective, with a low rate of side effects. Splenic pain and abdominal discomfort completely improved and cytopenias rised to secure levels. |
| Databáze: | OpenAIRE |
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