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. 2018 Sep-Oct;23(5):392-397.
doi: 10.1016/j.rpor.2018.07.011. Epub 2018 Aug 13.

Clinical and dosimetric factors associated with the development of hematologic toxicity in locally advanced cervical cancer treated with chemotherapy and 3D conformal radiotherapy

Miguel Ángel Souto-Del Bosque  1 , Miguel Ángel Cervantes-Bonilla  1 , Gerardo Del Carmen Palacios-Saucedo  2
Affiliations

Clinical and dosimetric factors associated with the development of hematologic toxicity in locally advanced cervical cancer treated with chemotherapy and 3D conformal radiotherapy

Miguel Ángel Souto-Del Bosque et al. Rep Pract Oncol Radiother. 2018 Sep-Oct.

Abstract

Aim: To identify clinical and dosimetric factors associated with the development of hematologic toxicity (HT) for cervical cancer (CC) treated with chemotherapy and 3D conformal radiotherapy.

Background: Chemoradiotherapy is the standard of care management for CC patients with IB2-IVA clinical stages (CS). This treatment carries toxicities, standing out the one that occurs at the hematologic level.

Subjects and methods: CC patients with IB2-IVA CS treated with chemotherapy and 3D conformal radiotherapy (50 Gy) plus Brachyterapy (7 Gy x3 or 9 Gy x2) at our institution between March 2016 and March 2017. Clinical and dosimetric factors were studied as was their probable association with the development of HT.

Results: 59 patients were analyzed. 89.8% of the subjects developed some grade of HT and 50.2% developed ≥grade 2 toxicity. No statistical relationship was found for the dosimetric factors: V10 > 90% (p = 0.47) and V20 > 80% (p = 0.17). Regarding clinical factors: neither age >50 years (p = 0.88) nor diabetes mellitus (DM) showed statistical relationship with development of ≥grade 2 HT (p = 0.88 and p = 0.61, respectively). On the contrary, obesity showed a significant association (p = 0.02). For other factors analyzed, we found statistical correlation for epidermoid histology and ≥III A CS (p = 0.01 and p = 0.02, respectively).

Conclusions: We did not find statistical relationship between HT and the clinical factors of age >50 years and DM. Statistical relationship for the dosimetric factors V10 > 90% and V20 > 80% was not found as well. On the contrary, obesity, epidermoid histology and ≥IIIA CS, showed statistical significance for development of HT ≥grade 2.

Keywords: Cervical cancer; Chemoradiotherapy; Hematologic toxicity.

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Figures

Fig. 1
Fig. 1
Dose distribution in 3D conformal technique.
See this image and copyright information in PMC

References

    1. Ginsburg O., Bray F., Coleman M.P. The global burden of women's cancers: a grand challenge in global health. Lancet. 2017;389:847–860. - PMC - PubMed
    1. Gómez H., Lamadrid H., Cahuana L. The burden of cancer in Mexico, 1990–2013. Salud Publica Mex. 2016;58:118–131. - PubMed
    1. Pecorelli S., Zigliani L., Odicino F. Reviced FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet. 2009;105:107–108. - PubMed
    1. Morris M., Eifel P.J., Lu J., Grigsby P.W. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high risk cervical cancer. N Engl J Med. 1999;340:1137–1143. - PubMed
    1. Keys H.M., Bundy B.N., Stehman F.B. Cisplatin, radiation, and adyuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical cancer. N Engl J Med. 1999;340:1156–1161. - PubMed

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