Association between dose-volume parameters and acute bone marrow suppression in rectal cancer patients treated with concurrent chemoradiotherapy
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Nan Li1, Xue Liu1, Fushan Zhai1, Bing Liu1, Xiaohui Cao1, Shuyan Li1, Minxian Zhang1 and Ming Liu1
1Department of Radiotherapy and Oncology, Third Hospital of Hebei Medical University, Shijiazhuang, China
Ming Liu, email: [email protected]
Keywords: concurrent chemoradiotherapy, acute bone marrow suppression, dose-volume parameters, rectal cancer, pelvic bone marrow
Received: July 13, 2017 Accepted: August 27, 2017 Published: October 06, 2017
Concurrent chemoradiotherapy is one of the main treatments for rectal cancer. Bone marrow suppression is one of the critical factors that affect the progress of radiotherapy. We aimed to explore the association of incidence of acute bone marrow suppression with dose-volume parameters of pelvic bone marrow among rectal cancer patients with concurrent chemoradiotherapy. We retrospectively analyzed 50 rectal cancer patients for multivariate logistic regression analyses. Three subdomains of pelvic bone marrow (PBM), bilateral ilium (IBM), lower pelvis (LPBM), and lumbosacral spine (LSBM) were assigned. The radiation dose-volume parameters from the three subdomains and the whole pelvis were evaluated. Compared to Grade 0-1 leukopenia patients, ≥Grade 2 leukopenia patients exhibited significantly higher levels of IBM V20, V25, V35, mean dose (Dmean), LPBM V20, V25, V30, LSBM V15, PBM V15, V20, and PTV. The PBM V20 of ≥Grade 2 neutropenia patients was significantly higher than that of Grade 0-1 neutropenia patients. Multivariate analysis have demonstrated that IBM V20 and LSBM V15 were the independent factors affecting ≥ Grade 2 leukopenia. There is a correlation between low dose-volume parameters with acute bone marrow suppression. IBM V20, LSBM V15 and PBM V20 can be employed as the predictors of acute bone marrow suppression.
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