Effect of Pelvic Bone Marrow Sparing Intensity Modulated Radiation Therapy on Acute Hematologic Toxicity in Rectal Cancer Patients Undergoing Chemo-Radiotherapy

• DOI: 10.3389/fonc.2021.646211
• Publication Date: 2021-04-22T16:01:35Z
• Authors: Wei Huang; Jun Dang; Ying Li; Hai-xia Cui; Wen-li Lu; Qing-feng Jiang
• Keywords: Bone marrow suppression

Background While chemo-radiotherapy improves local control in patients with locally advanced rectal cancer, it can also increase acute hematological toxicity (HT), which leads to poor outcomes. Patients receiving bone marrow radiation have been shown develop HT. However, the safety and efficacy of sparing is undetermined. The aim our study was explore feasible dosimetric constraints for pelvic (PBM) that be widely used cancer undergoing chemo-radiotherapy. Methods 112 were selected divided into PBM IMRT group (60 cases) non-PBM (52 cases). All underwent radiotherapy concurrent capecitabine-based chemotherapy. set to:V 10 ≤ 85%, V 20 65% 30 45%. An independent sample t test applied dose-volume parameters, Chi-squared analysis clinical parameters adverse events. Results dose (V 5 ~V 45 , D mean P <0.05), sub-regions 35 <0.05) both femoral heads 40 decreased significantly compared ( <0.05). There no significant difference any bladder small bowel either groups, none planning target volume (PTV) homogeneity conformity >0.05). For HT observation, incidence grade 3 (χ 2 = 7.094, =0.008) reduced treated IMRT. statistical vomiting, diarrhea, fatigue, anorexia, nausea, hand-foot syndrome, cystitis, perianal pain dermatitis groups > 0.05). Conclusions Applying 45%) reduce PBM. had a lower those proposed by benefits