Dose–volume effects for pelvic bone marrow in predicting hematological toxicity in prostate cancer radiotherapy with pelvic node irradiation

Autor: Sini Carla, Fiorino Claudio, Perna Lucia, Chiorda Barbara Noris, Deantoni Chiara Lucrezia, Bianchi Marco, Sacco Vincenzo, Briganti Alberto, MONTORSI , FRANCESCO, Calandrino Riccardo, Di Muzio Nadia, Cozzarini Cesare, DI MUZIO, NADIA GISELLA
Přispěvatelé: Sini, Carla, Fiorino, Claudio, Perna, Lucia, Chiorda Barbara, Nori, Deantoni Chiara, Lucrezia, Bianchi, Marco, Sacco, Vincenzo, Briganti, Alberto, Montorsi, Francesco, Calandrino, Riccardo, Di Muzio, Nadia, Cozzarini, Cesare, DI MUZIO, NADIA GISELLA
Rok vydání: 2016
Předmět:
Male
Oncology
Radiology
Nuclear Medicine and Imaging
medicine.medical_treatment
Hematologic toxicity
030218 nuclear medicine & medical imaging
Prostate cancer
0302 clinical medicine
Bone Marrow
Prospective Studies
Radiation Injurie
Radiotherapy Dosage
Chemoradiotherapy
Hematology
Middle Aged
medicine.anatomical_structure
030220 oncology & carcinogenesis
Adjuvant
Human
medicine.medical_specialty
Intensity-modulated radiotherapy
Whole-Pelvis
Tomotherapy
03 medical and health sciences
Pelvic Bone
Lymphopenia
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Risk factor
Pelvic Bones
Radiation Injuries
Radiometry
Aged
Salvage Therapy
Lymphatic Irradiation
business.industry
Prostatic Neoplasms
Hematologic Disease
medicine.disease
Hematologic Diseases
Radiation therapy
Prospective Studie
Prostatic Neoplasm
Radiotherapy
Adjuvant
Radiotherapy
Intensity-Modulated
Bone marrow
Radiotherapy
Conformal
business
Lumbosacral joint
Zdroj: Radiotherapy and Oncology. 118:79-84
ISSN: 0167-8140
DOI: 10.1016/j.radonc.2015.11.020
Popis: Purpose To prospectively identify clinical/dosimetric predictors of acute/late hematologic toxicity (HT) in chemo-naÏve patients treated with whole-pelvis radiotherapy (WPRT) for prostate cancer. Material and methods Data of 121 patients treated with adjuvant/salvage WPRT were analyzed (static-field IMRT n = 19; VMAT/Rapidarc n = 57; Tomotherapy n = 45). Pelvic bone marrow (BM) was delineated as ilium (IL), lumbosacral, lower and whole pelvis (WP), and the relative DVHs were calculated. HT was graded both according to CTCAE v4.03 and as variation in percentage relative to baseline. Logistic regression was used to analyze association between HT and clinical/DVHs factors. Results Significant differences (p < 0.005) in the DVH of BM volumes between different techniques were found: Tomotherapy was associated with larger volumes receiving low doses (3-20 Gy) and smaller receiving 40-50 Gy. Lower baseline absolute values of WBC, neutrophils and lymphocytes (ALC) predicted acute/late HT (p ≤ 0.001). Higher BM V40 was associated with higher risk of acute Grade3 (OR = 1.018) or late Grade2 lymphopenia (OR = 1.005). Two models predicting lymphopenia were developed, both including baseline ALC, and BM WP-V40 (AUC = 0.73) and IL-V40+smoking (AUC = 0.904) for acute/late respectively. Conclusions Specific regions of pelvic BM predicting acute/late lymphopenia, a risk factor for viral infections, were identified. The 2-variable models including specific constraints to BM may help reduce HT.
Databáze: OpenAIRE
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