IMR Press / EJGO / Volume 35 / Issue 1 / DOI: 10.12892/ejgo23912014

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Comparison of hematologic toxicity between 3DCRT and IMRT planning in cervical cancer patients after concurrent chemoradiotherapy: a national multi-center study
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1 Medical School of Gazi University, Department of Radiation Oncology, Ankara
2 Florence Nightingale Hospital, Department of Radiation Oncology, Istanbul
3 Medical School of Acibadem University, Department of Radiation Oncology, Istanbul
4 Medical School of Bilim University, Department of Radiation Oncology, Istanbul
5 Acibadem Hospital, Department of Radiation Oncology, Istanbul
6 Istanbul University Oncology Institute, Department of Radiation Oncology, Istanbul
7 Medical School of Ege University, Department of Radiation Oncology, Izmir
8 Dr. Abdurrahman Yurtaslan Oncology Training & Research Hospital, Ankara Department of Radiation Oncology, Ankara
9 Medical School of Osmangazi University, Department of Radiation Oncology, Eskisehir
10 American Hospital, Department of Medical Oncology, Istanbul (Turkey)
Eur. J. Gynaecol. Oncol. 2014, 35(1), 62–66; https://doi.org/10.12892/ejgo23912014
Published: 10 February 2014
Abstract

Purpose: To compare the incidence and severity of acute and chronic hematologic toxicity (HT) in patients treated with three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) for curative treatment of cervical cancer and to ascertain the dosimetric parameters of two techniques associated with acute and chronic HT. Materials and Methods: A total of 127 patients with cervical cancer receiving concomitant pelvic radiotherapy (RT) and cisplatin were evaluated. Pelvic bone marrow (BM) was contoured for each patient and divided into five sub-regions: lumbosacrum (LS), ilium (IL), lower pelvis (LP), pelvis (P), and whole pelvis (WP). The volume of each BM region receiving 10,20,30, and 40 Gy was calculated (V10, -V20, -V30, and -V40). The lowest level of hemoglobin, leukocyte, neutrophil, and platelet counts were obtained during chemoradiotherapy and six months after RT. The nadir values were graded according to Common Terminology Criteria for Adverse Events (version 3.0). Results: Grade 2 or greater acute anemia, leukopenia, neutropenia, thrombocytopenia was observed in 2%, 41.5%, 12% ,and 0% in 3DCRT group and in 27%, 53%, 24.5%, and 4.5% in IMRT group, respectively. Grade 2 or greater chronic anemia, leukopenia, neutropenia, and thrombocytopenia was observed in 11%, 10%, 6%, and 0% in 3DCRT group and in 11%, 9%, 4.5%, and 0% in IMRT group, respectively. LSV30,40; IL-V10,20,30,40; LP-V10,20,40; P-V10,20,30,40, and TP-V10,20,30,40 were significantly reduced with IMRT planning compared to 3DCRT planning. Logistic regression analysis of potential predictors showed that none of the dosimetric parameters were significant for predicting acute and chronic HT. Conclusion: The present findings showed that IMRT planning reduced irradiated BM volumes compared to 3DCRT planning. However, no difference between the two techniques was observed in terms of acute and chronic HT. Further studies are needed to confirm these results.
Keywords
Hematologic toxicity
Cervical cancer
Radiotherapy
Chemotherapy
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