Long-Term Bone Marrow Suppression During Postoperative Chemotherapy in Rectal Cancer Patients After Preoperative Chemoradiation Therapy
作者： Neil B. Newman , Manpreet K. Sidhu , Rekha Baby , Rebecca A. Moss , Michael J. Nissenblatt
DOI: 10.1016/J.IJROBP.2015.12.374
关键词: Urology 、 Bone marrow 、 Colorectal cancer 、 Chemoradiotherapy 、 Fluorouracil 、 Preoperative care 、 Medicine 、 Surgery 、 Oxaliplatin 、 Bone marrow suppression 、 Chemotherapy
摘要: Purpose/Objective(s) To quantify ensuing bone marrow (BM) suppression during postoperative chemotherapy resulting from preoperative chemoradiation (CRT) therapy for rectal cancer. Methods and Materials We retrospectively evaluated 35 patients treated with CRT followed by 5-Fluorouracil oxaliplatin (OxF) locally advanced The pelvic (PBM) was divided into ilium (IBM), lower pelvis (LPBM), lumbosacrum (LSBM). Dose volume histograms (DVH) measured the mean doses percentage of BM receiving between 5-40 Gy (i.e.: PBM-V5, LPBM-V5). Wilcoxon signed rank tests differences in absolute hematologic nadirs neoadjuvant vs. adjuvant treatment. Logistic regressions association dosimetric parameters ≥ grade 3 toxicity (HT3) event (HE) defined as 2 HT a dose reduction OxF. Receiver Operator Characteristic (ROC) curves were constructed to determine optimal threshold values leading HT3. Results During OxF chemotherapy, 40.0% (n=14) 48% (n=17) cancer experienced HT3 HE, respectively. On multivariable logistic regression, increasing (PMD) (LPMD) along PBM-V (25-40), LPBM-V25, LPBM-V40 significantly associated and/or HE chemotherapy. Exceeding ≥36.6 PMD ≥32.6 LPMD strongly correlated causing Conclusions Neoadjuvant RT has lasting effects on BM, which are demonstrable Sparing can aid reducing significant adverse events tolerance
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