Early hematologic changes during prostate cancer radiotherapy predictive for late urinary and bowel toxicity

Background The primary objective of the study was to identify early hematologic changes predictive for radiotherapy (RT)-associated genitourinary and gastrointestinal toxicity. Methods In a group of 91 prostate cancer patients presenting for primary ( n  = 51) or postoperative ( n  = 40) curative RT...

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Bibliographic Details
Published in:Strahlentherapie und Onkologie 2015-10, Vol.191 (10), p.771-777
Main Authors: Pinkawa, Michael, Ribbing, Carolina, Djukic, Victoria, Klotz, Jens, Holy, Richard, Eble, Michael J.
Format: Article
Language:English
Subjects:
Acute-Phase Proteins - metabolism
Aged
Aged, 80 and over
Blood Cell Count
C-Reactive Protein - metabolism
Cytokines - blood
Gastrointestinal Tract - radiation effects
Hemoglobinometry
Humans
Interleukin-6 - blood
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Oncology
Original Article
Prostatic Neoplasms - blood
Prostatic Neoplasms - pathology
Prostatic Neoplasms - radiotherapy
Prostatic Neoplasms - surgery
Quality of Life
Radiation Injuries - blood
Radiation Injuries - diagnosis
Radiotherapy
Radiotherapy, Adjuvant
Urogenital System - radiation effects
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Summary:Background The primary objective of the study was to identify early hematologic changes predictive for radiotherapy (RT)-associated genitourinary and gastrointestinal toxicity. Methods In a group of 91 prostate cancer patients presenting for primary ( n  = 51) or postoperative ( n  = 40) curative RT, blood samples (blood count, acute phase proteins, and cytokines) were analyzed before (T1), three times during (T2–T4), and 6–8 weeks after (T5) radiotherapy. Before RT (baseline), on the last day (acute toxicity), a median of 2 months and 16 months (late toxicity) after RT, patients responded to a validated questionnaire (Expanded Prostate Cancer Index Composite). Acute score changes > 20 points and late changes > 10 points were considered clinically relevant. Results Radiotherapy resulted in significant changes of hematologic parameters, with the largest effect on lymphocytes (mean decrease of 31–45 %) and significant dependence on target volume. C-reactive protein (CRP) elevation > 5 mg/l and hemoglobin level decrease ≥ 5 G/1 at T2 were found to be independently predictive for acute urinary toxicity ( p  
ISSN:0179-7158
1439-099X
DOI:10.1007/s00066-015-0841-3