• Je něco špatně v tomto záznamu ?

Comparison of Hematologic Toxicity and Bone Marrow Compensatory Response in Head and Neck vs. Cervical Cancer Patients Undergoing Chemoradiotherapy

LK. Vitzthum, ES. Heide, H. Park, CW. Williamson, P. Sheridan, MP. Huynh-Le, I. Sirak, L. Wei, R. Tarnawski, U. Mahantshetty, C. Nguyen, J. Mayadev, CM. Yashar, AG. Sacco, LK. Mell,

. 2020 ; 10 (-) : 1179. [pub] 20200721

Jazyk angličtina Země Švýcarsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc20021948

Background: Hematologic toxicity is a critical problem limiting treatment delivery in cancer patients undergoing concurrent chemoradiotherapy. However, the extent to which anatomic variations in radiation dose limit chemotherapy delivery is poorly understood. A unique natural experiment arises in patients with head and neck and cervical cancer, who frequently undergo identical chemotherapy but receive radiation to different regions of the body. Comparing these cohorts can help elucidate to what extent hematologic toxicity is attributable to marrow radiation as opposed to chemotherapy. Methods: In this longitudinal cohort study, we compared hematologic toxicity and bone marrow compensatory response in 148 patients (90 cervix, 58 head/neck) undergoing chemoradiotherapy with concurrent weekly cisplatin 40 mg/m2. We used linear mixed effect models to compare baseline and time-varying peripheral cell counts and hemoglobin levels between cohorts. To assess bone marrow compensatory response, we measured the change in metabolically active bone marrow (ABM) volume on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Results: We observed greater reductions in log-transformed lymphocyte, platelet, and absolute neutrophil counts (ANC) for cervix compared to head/neck cancer patients (fixed effects for time-cohort interaction [95% CI]: lymphocytes, -0.06 [-0.09, -0.031]; platelets,-0.028 [-0.051, -0.0047]; ANC, -0.043 [-0.075, -0.011]). Mean ANC nadirs were also lower for cervical vs. head/neck cancer cohorts (2.20 vs. 2.85 × 103 per μL, p < 0.01). Both cohorts exhibited reductions in ABM volume within the radiation field, and increases in ABM volume in out-of-field areas, indicating varying compensatory response to radiation injury. Conclusions: Cervical cancer patients had faster decreases in ANC, lymphocyte, and platelet counts, and lower ANC nadirs, indicating a significant effect of pelvic irradiation on acute peripheral blood cell counts. Both cohorts exhibited a compensatory response with increased out-of-field bone marrow activity.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc20021948
003      
CZ-PrNML
005      
20201204093430.0
007      
ta
008      
201125s2020 sz f 000 0|eng||
009      
AR
024    7_
$a 10.3389/fonc.2020.01179 $2 doi
035    __
$a (PubMed)32793487
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a sz
100    1_
$a Vitzthum, Lucas K $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
245    10
$a Comparison of Hematologic Toxicity and Bone Marrow Compensatory Response in Head and Neck vs. Cervical Cancer Patients Undergoing Chemoradiotherapy / $c LK. Vitzthum, ES. Heide, H. Park, CW. Williamson, P. Sheridan, MP. Huynh-Le, I. Sirak, L. Wei, R. Tarnawski, U. Mahantshetty, C. Nguyen, J. Mayadev, CM. Yashar, AG. Sacco, LK. Mell,
520    9_
$a Background: Hematologic toxicity is a critical problem limiting treatment delivery in cancer patients undergoing concurrent chemoradiotherapy. However, the extent to which anatomic variations in radiation dose limit chemotherapy delivery is poorly understood. A unique natural experiment arises in patients with head and neck and cervical cancer, who frequently undergo identical chemotherapy but receive radiation to different regions of the body. Comparing these cohorts can help elucidate to what extent hematologic toxicity is attributable to marrow radiation as opposed to chemotherapy. Methods: In this longitudinal cohort study, we compared hematologic toxicity and bone marrow compensatory response in 148 patients (90 cervix, 58 head/neck) undergoing chemoradiotherapy with concurrent weekly cisplatin 40 mg/m2. We used linear mixed effect models to compare baseline and time-varying peripheral cell counts and hemoglobin levels between cohorts. To assess bone marrow compensatory response, we measured the change in metabolically active bone marrow (ABM) volume on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Results: We observed greater reductions in log-transformed lymphocyte, platelet, and absolute neutrophil counts (ANC) for cervix compared to head/neck cancer patients (fixed effects for time-cohort interaction [95% CI]: lymphocytes, -0.06 [-0.09, -0.031]; platelets,-0.028 [-0.051, -0.0047]; ANC, -0.043 [-0.075, -0.011]). Mean ANC nadirs were also lower for cervical vs. head/neck cancer cohorts (2.20 vs. 2.85 × 103 per μL, p < 0.01). Both cohorts exhibited reductions in ABM volume within the radiation field, and increases in ABM volume in out-of-field areas, indicating varying compensatory response to radiation injury. Conclusions: Cervical cancer patients had faster decreases in ANC, lymphocyte, and platelet counts, and lower ANC nadirs, indicating a significant effect of pelvic irradiation on acute peripheral blood cell counts. Both cohorts exhibited a compensatory response with increased out-of-field bone marrow activity.
655    _2
$a časopisecké články $7 D016428
700    1_
$a Heide, Elena S $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Park, Helen $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Williamson, Casey W $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Sheridan, Paige $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Huynh-Le, Minh-Phuong $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Sirak, Igor $u Department of Oncology and Radiotherapy, University Hospital in Hradec Kralove, Hradec Kralove, Czechia.
700    1_
$a Wei, Lichun $u Department of Radiation Oncology, Xijing Hospital, Xi'an, China.
700    1_
$a Tarnawski, Rafal $u Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
700    1_
$a Mahantshetty, Umesh $u Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
700    1_
$a Nguyen, Cammie $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Mayadev, Jyoti $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Yashar, Catheryn M $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Sacco, Assuntina G $u Department of Hematology and Oncology, University of California, San Diego, La Jolla, CA, United States.
700    1_
$a Mell, Loren K $u Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA, United States.
773    0_
$w MED00182989 $t Frontiers in oncology $x 2234-943X $g Roč. 10, č. - (2020), s. 1179
856    41
$u https://pubmed.ncbi.nlm.nih.gov/32793487 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20201125 $b ABA008
991    __
$a 20201204093428 $b ABA008
999    __
$a ind $b bmc $g 1591656 $s 1112620
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2020 $b 10 $c - $d 1179 $e 20200721 $i 2234-943X $m Frontiers in oncology $n Front Oncol $x MED00182989
LZP    __
$a Pubmed-20201125

Najít záznam

Citační ukazatele

Možnosti archivace