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. 2020 Jul 29;20(1):702.
doi: 10.1186/s12885-020-07168-7.

Assessment of the results and hematological side effects of 3D conformal and IMRT/ARC therapies delivered during craniospinal irradiation of childhood tumors with a follow-up period of five years

Zoltán Lőcsei  1 , Róbert Farkas  2 , Kornélia Borbásné Farkas  3 , Klára Sebestyén  4 , Zsolt Sebestyén  4 , Zoltán Musch  4 , Ágnes Vojcek  5 , Noémi Benedek  5 , László Mangel  4 , Gábor Ottóffy  5
Affiliations

Assessment of the results and hematological side effects of 3D conformal and IMRT/ARC therapies delivered during craniospinal irradiation of childhood tumors with a follow-up period of five years

Zoltán Lőcsei et al. BMC Cancer. .

Abstract

Background: Craniospinal irradiation (CSI) of childhood tumors with the RapidArc technique is a new method of treatment. Our objective was to compare the acute hematological toxicity pattern during 3D conformal radiotherapy with the application of the novel technique.

Methods: Data from patients treated between 2007 and 2014 were collected, and seven patients were identified in both treatment groups. After establishing a general linear model, acute blood toxicity results were obtained using SPSS software. Furthermore, the exposure dose of the organs at risk was compared. Patients were followed for a minimum of 5 years, and progression-free survival and overall survival data were assessed.

Results: After assessment of the laboratory parameters in the two groups, it may be concluded that no significant differences were detected in terms of the mean dose exposures of the normal tissues or the acute hematological side effects during the IMRT/ARC and 3D conformal treatments. Laboratory parameters decreased significantly compared to the baseline values during the treatment weeks. Nevertheless, no significant differences were detected between the two groups. No remarkable differences were confirmed between the two groups regarding the five-year progression-free survival or overall survival, and no signs of serious organ toxicity due to irradiation were observed during the follow-up period in either of the groups.

Conclusion: The RapidArc technique can be used safely even in the treatment of childhood tumors, as the extent of the exposure dose in normal tissues and the amount of acute hematological side effects are not higher with this technique.

Keywords: Childhood cancer; Craniospinal irradiation; Medulloblastoma; RapidArc.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial, financial or nonfinancial relationship that could be construed as a potential competing interest.

Figures

Fig. 1
Fig. 1
OAR dose exposures (cGy) during the treatments carried out with the two radiotherapeutic modalities. 3DCRT in blue and IMRT/ARC therapy in orange
Fig. 2
Fig. 2
Neutrophil counts for all patients (G/l) during the treatment weeks. The decrease in the weekly mean value of neutrophil granulocytes during the treatment. A significant decrease can be observed during the treatment weeks; however, there is no difference between the two groups. (Orange: 3D-conformal plan, Blue: IMRT/ARC plan)
Fig. 3
Fig. 3
White blood cell counts for all patients (G/l) during the treatment weeks. The decrease in the weekly mean value of white blood cell counts during treatment. A significant decrease can be observed during treatment weeks; however, there is no difference between the two groups. (Orange: 3D-conformal plan, Blue: IMRT/ARC plan)
Fig. 4
Fig. 4
Platelet counts for all patients (G/l) during the treatment weeks. The decrease in the weekly mean value of platelets during treatment. A significant decrease can be observed during treatment weeks; however, there is no difference between the two groups. (Orange: 3D-conformal plan, Blue: IMRT/ARC plan)
Fig. 5
Fig. 5
Progression-free survival. All patient curves over the years. 3DCRT in blue and IMRT/ARC in orange
Fig. 6
Fig. 6
Overall survival data. All patient curves over the years. 3DCRT in blue and IMRT/ARC in orange
See this image and copyright information in PMC

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