Normal tissue complication probability modeling of acute hematologic toxicity in cervical cancer patients treated with chemoradiotherapy
| Autor: | M. Yeginer, Loren K. Mell, Catheryn M. Yashar, Y. Liang, Arno J. Mundt, Bulent Aydogan, Michael D. Hasselle, Rounak Bafana, Brent S. Rose, Virag Dandekar, John C. Roeske |
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| Rok vydání: | 2009 |
| Předmět: |
Organs at Risk
Cancer Research medicine.medical_specialty Neutrophils Urology Uterine Cervical Neoplasms Antineoplastic Agents Article Body Mass Index Pelvis Leukocyte Count Bone Marrow White blood cell medicine Humans Radiology Nuclear Medicine and imaging Radiation Injuries Probability Cervical cancer Radiation Leukopenia Models Statistical Receiver operating characteristic business.industry Platelet Count Hemoglobin A Radiotherapy Dosage Middle Aged medicine.disease Combined Modality Therapy Surgery medicine.anatomical_structure Oncology Cohort Female Bone marrow Radiotherapy Intensity-Modulated medicine.symptom Cisplatin business Complication Chemoradiotherapy |
| Zdroj: | International journal of radiation oncology, biology, physics. 79(3) |
| ISSN: | 1879-355X |
| Popis: | Purpose To test the hypothesis that increased pelvic bone marrow (BM) irradiation is associated with increased hematologic toxicity (HT) in cervical cancer patients undergoing chemoradiotherapy and to develop a normal tissue complication probability (NTCP) model for HT. Methods and Materials We tested associations between hematologic nadirs during chemoradiotherapy and the volume of BM receiving ≥10 and 20 Gy (V 10 and V 20 ) using a previously developed linear regression model. The validation cohort consisted of 44 cervical cancer patients treated with concurrent cisplatin and pelvic radiotherapy. Subsequently, these data were pooled with data from 37 identically treated patients from a previous study, forming a cohort of 81 patients for normal tissue complication probability analysis. Generalized linear modeling was used to test associations between hematologic nadirs and dosimetric parameters, adjusting for body mass index. Receiver operating characteristic curves were used to derive optimal dosimetric planning constraints. Results In the validation cohort, significant negative correlations were observed between white blood cell count nadir and V 10 (regression coefficient (β) = −0.060, p = 0.009) and V 20 (β = −0.044, p = 0.010). In the combined cohort, the (adjusted) β estimates for log (white blood cell) vs. V 10 and V 20 were as follows: −0.022 ( p = 0.025) and −0.021 ( p = 0.002), respectively. Patients with V 10 ≥ 95% were more likely to experience Grade ≥3 leukopenia (68.8% vs. 24.6%, p 20 > 76% (57.7% vs. 21.8%, p = 0.001). Conclusions These findings support the hypothesis that HT increases with increasing pelvic BM volume irradiated. Efforts to maintain V 10 20 |
| Databáze: | OpenAIRE |
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