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

• Published in: Frontiers in oncology 2021-04, Vol.11, p.646211
• Main Authors: Huang, Wei, Dang, Jun, Li, Ying, Cui, Hai-Xia, Lu, Wen-Li, Jiang, Qing-Feng
• Format: Article
• Language: English
• Subjects: acute hematologic toxicity; chemo-radiotherapy; IMRT; Oncology; pelvic bone marrow; rectal cancer
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2021.646211

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 to develop acute HT. However, the safety and efficacy of bone marrow sparing is undetermined. The aim of our study was to explore the feasible dosimetric constraints for pelvic bone marrow (PBM) that can be widely used in rectal cancer patients undergoing chemo-radiotherapy. 112 rectal cancer patients were selected and divided into the PBM sparing IMRT group (60 cases) and the non-PBM sparing IMRT group (52 cases). All patients underwent pelvic radiotherapy with concurrent capecitabine-based chemotherapy. The PBM dosimetric constraints in the PBM sparing IMRT group were set to:V ≤ 85%, V ≤ 65% and V ≤ 45%. An independent sample t test was applied for the dose-volume parameters, and Chi-squared analysis was applied for clinical parameters and adverse events. The radiation dose to PBM (V ~V , D ,