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作者

Wang, Dandan Nie, Shengnan Yin, Yueju Ma, Xingmin Li, Dapeng Zhu, Jian

作者单位

Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China Department of Graduate, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China Shandong Medical Imaging and Radiotherapy Engineering Center, Jinan, 250117, China

刊名

Chinese Journal of Cancer Prevention and Treatment

年份

2021

卷号

Vol.28 No.12

页码

927

ISSN

1673-5269

摘要

Objective: To compare the difference of acute hematotoxicity caused by fixed-field intensity-modulated radiotherapy and helical tomotherapy in cervical cancer patients with concurrent for chemoradiotherapy, and to analyze the radiation dosimetry parameters causing the difference. Methods: The study enrolled 232 patients in Shandong cancer Hospital and Institute from January 1, 2016 to September 30, 2018, who are pathologically diagnosed stage ⅡA-ⅣA cervical cancer as per the staging criteria of ...更多

Objective: To compare the difference of acute hematotoxicity caused by fixed-field intensity-modulated radiotherapy and helical tomotherapy in cervical cancer patients with concurrent for chemoradiotherapy, and to analyze the radiation dosimetry parameters causing the difference. Methods: The study enrolled 232 patients in Shandong cancer Hospital and Institute from January 1, 2016 to September 30, 2018, who are pathologically diagnosed stage ⅡA-ⅣA cervical cancer as per the staging criteria of the International Federation of Gynecology and Obstetrics, and the patients were received ff-IMRT and HT radiotherapy, respectively. There were 118 patients in ff-IMRT group and 114 patients in HT group. The data of dose-volume histogram with each patient were recorded. The dose volume of pelvic bone irradiation in the two groups were evaluated, the blood cells count of acute leukopenia and neutropenia during radiotherapy were recorded, and the numbers of the patients receiving recombinant human granulocyte colony stimulating factor were recorded. Independent sample t-test was performed to test the differences of acute hematotoxicity and pelvic bone dose volume between ff-IMRT and HT groups. Results: There was no significant difference in patient age, pathological type, TNM stage and radiation prescription dose between ff-IMRT and HT groups. According to the criteria of RTOG, the incidence of ≥grade 1 acute hematotoxicity was 118 and 109 in ff-IMRT and HT groups, respectively. The incidence of acute leukopenia: 118 and 109, t=-2.317, P=0.021. The incidence of acute neutropenia: 97 and 90, t=-0.624, P=0.210. There was no significant difference in other parameters between the two groups. There were significant differences in dose-volume parameter of pelvic bone marrow at V5-V45 . The patients both in the ff-IMRT group and the HT group, who were injected with recombinant human granulocyte colony-stimulating factor injection once appear ≥grade 1 hematotoxicity during concurrent chemoradiotherapy. The results showed that the average amount of drugs in the ff-IMRT group were significantly higher than those in the HT group , with the difference being statistically significant . Conclusions: Compared with ff-IMRT, HT significantly reduced the incident of ≥grade 1 acute hematotoxicity for cervical cancer patients with concurrent chemotherapy, and the dose volume parameters in V5-V45 in HT group were lower than those in ff-IMRT group. It is demonstrated that HT technique has advantages in reducing the dose of pelvis bone morrow and acute hematological toxicity caused by radiation.收起

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