Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer

Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Franco, P. [verfasserIn] Ragona, R. [verfasserIn] Arcadipane, F. [verfasserIn] Mistrangelo, M. [verfasserIn] Cassoni, P. [verfasserIn] Rondi, N. [verfasserIn] Morino, M. [verfasserIn] Racca, P. [verfasserIn] Ricardi, U. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Anal cancer IMRT Volumetric modulated arc-therapy VMAT Concomitant radiochemotherapy Acute toxicity Radiotherapy Radiation

Übergeordnetes Werk:	Enthalten in: Revista de oncología - Barcelona : Doyma, 2000, 19(2016), 1 vom: 01. Apr., Seite 67-75
Übergeordnetes Werk:	volume:19 ; year:2016 ; number:1 ; day:01 ; month:04 ; pages:67-75

Links:	Volltext

DOI / URN:	10.1007/s12094-016-1504-2

Katalog-ID:	SPR02426539X

Internformat


LEADER	01000caa a22002652 4500
001	SPR02426539X
003	DE-627
005	20230519164628.0
007	cr uuu---uuuuu
008	201006s2016 xx \|\|\|\|\|o 00\| \|\|eng c
024	7		\|a 10.1007/s12094-016-1504-2 \|2 doi
035			\|a (DE-627)SPR02426539X
035			\|a (SPR)s12094-016-1504-2-e
040			\|a DE-627 \|b ger \|c DE-627 \|e rakwb
041			\|a eng
082	0	4	\|a 610 \|q ASE
100	1		\|a Franco, P. \|e verfasserin \|4 aut
245	1	0	\|a Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
264		1	\|c 2016
336			\|a Text \|b txt \|2 rdacontent
337			\|a Computermedien \|b c \|2 rdamedia
338			\|a Online-Ressource \|b cr \|2 rdacarrier
520			\|a Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT.
650		4	\|a Anal cancer \|7 (dpeaa)DE-He213
650		4	\|a IMRT \|7 (dpeaa)DE-He213
650		4	\|a Volumetric modulated arc-therapy \|7 (dpeaa)DE-He213
650		4	\|a VMAT \|7 (dpeaa)DE-He213
650		4	\|a Concomitant radiochemotherapy \|7 (dpeaa)DE-He213
650		4	\|a Acute toxicity \|7 (dpeaa)DE-He213
650		4	\|a Radiotherapy \|7 (dpeaa)DE-He213
650		4	\|a Radiation \|7 (dpeaa)DE-He213
700	1		\|a Ragona, R. \|e verfasserin \|4 aut
700	1		\|a Arcadipane, F. \|e verfasserin \|4 aut
700	1		\|a Mistrangelo, M. \|e verfasserin \|4 aut
700	1		\|a Cassoni, P. \|e verfasserin \|4 aut
700	1		\|a Rondi, N. \|e verfasserin \|4 aut
700	1		\|a Morino, M. \|e verfasserin \|4 aut
700	1		\|a Racca, P. \|e verfasserin \|4 aut
700	1		\|a Ricardi, U. \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|t Revista de oncología \|d Barcelona : Doyma, 2000 \|g 19(2016), 1 vom: 01. Apr., Seite 67-75 \|w (DE-627)385985452 \|w (DE-600)2143451-7 \|x 1578-195X \|7 nnns
773	1	8	\|g volume:19 \|g year:2016 \|g number:1 \|g day:01 \|g month:04 \|g pages:67-75
856	4	0	\|u https://dx.doi.org/10.1007/s12094-016-1504-2 \|z lizenzpflichtig \|3 Volltext
912			\|a GBV_USEFLAG_A
912			\|a SYSFLAG_A
912			\|a GBV_SPRINGER
912			\|a SSG-OLC-PHA
912			\|a GBV_ILN_20
912			\|a GBV_ILN_22
912			\|a GBV_ILN_23
912			\|a GBV_ILN_24
912			\|a GBV_ILN_31
912			\|a GBV_ILN_39
912			\|a GBV_ILN_40
912			\|a GBV_ILN_60
912			\|a GBV_ILN_62
912			\|a GBV_ILN_65
912			\|a GBV_ILN_69
912			\|a GBV_ILN_70
912			\|a GBV_ILN_73
912			\|a GBV_ILN_74
912			\|a GBV_ILN_90
912			\|a GBV_ILN_95
912			\|a GBV_ILN_100
912			\|a GBV_ILN_105
912			\|a GBV_ILN_120
912			\|a GBV_ILN_152
912			\|a GBV_ILN_161
912			\|a GBV_ILN_171
912			\|a GBV_ILN_187
912			\|a GBV_ILN_224
912			\|a GBV_ILN_250
912			\|a GBV_ILN_281
912			\|a GBV_ILN_285
912			\|a GBV_ILN_293
912			\|a GBV_ILN_370
912			\|a GBV_ILN_602
912			\|a GBV_ILN_702
951			\|a AR
952			\|d 19 \|j 2016 \|e 1 \|b 01 \|c 04 \|h 67-75

Indexfelder

author_variant	p f pf r r rr f a fa m m mm p c pc n r nr m m mm p r pr u r ur
matchkey_str	article:1578195X:2016----::oiercrdcosfcthmtlgcoiiyuigocretnestmdltdaitea
hierarchy_sort_str	2016
publishDate	2016
allfields	10.1007/s12094-016-1504-2 doi (DE-627)SPR02426539X (SPR)s12094-016-1504-2-e DE-627 ger DE-627 rakwb eng 610 ASE Franco, P. verfasserin aut Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT. Anal cancer (dpeaa)DE-He213 IMRT (dpeaa)DE-He213 Volumetric modulated arc-therapy (dpeaa)DE-He213 VMAT (dpeaa)DE-He213 Concomitant radiochemotherapy (dpeaa)DE-He213 Acute toxicity (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Radiation (dpeaa)DE-He213 Ragona, R. verfasserin aut Arcadipane, F. verfasserin aut Mistrangelo, M. verfasserin aut Cassoni, P. verfasserin aut Rondi, N. verfasserin aut Morino, M. verfasserin aut Racca, P. verfasserin aut Ricardi, U. verfasserin aut Enthalten in Revista de oncología Barcelona : Doyma, 2000 19(2016), 1 vom: 01. Apr., Seite 67-75 (DE-627)385985452 (DE-600)2143451-7 1578-195X nnns volume:19 year:2016 number:1 day:01 month:04 pages:67-75 https://dx.doi.org/10.1007/s12094-016-1504-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 19 2016 1 01 04 67-75
spelling	10.1007/s12094-016-1504-2 doi (DE-627)SPR02426539X (SPR)s12094-016-1504-2-e DE-627 ger DE-627 rakwb eng 610 ASE Franco, P. verfasserin aut Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT. Anal cancer (dpeaa)DE-He213 IMRT (dpeaa)DE-He213 Volumetric modulated arc-therapy (dpeaa)DE-He213 VMAT (dpeaa)DE-He213 Concomitant radiochemotherapy (dpeaa)DE-He213 Acute toxicity (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Radiation (dpeaa)DE-He213 Ragona, R. verfasserin aut Arcadipane, F. verfasserin aut Mistrangelo, M. verfasserin aut Cassoni, P. verfasserin aut Rondi, N. verfasserin aut Morino, M. verfasserin aut Racca, P. verfasserin aut Ricardi, U. verfasserin aut Enthalten in Revista de oncología Barcelona : Doyma, 2000 19(2016), 1 vom: 01. Apr., Seite 67-75 (DE-627)385985452 (DE-600)2143451-7 1578-195X nnns volume:19 year:2016 number:1 day:01 month:04 pages:67-75 https://dx.doi.org/10.1007/s12094-016-1504-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 19 2016 1 01 04 67-75
allfields_unstemmed	10.1007/s12094-016-1504-2 doi (DE-627)SPR02426539X (SPR)s12094-016-1504-2-e DE-627 ger DE-627 rakwb eng 610 ASE Franco, P. verfasserin aut Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT. Anal cancer (dpeaa)DE-He213 IMRT (dpeaa)DE-He213 Volumetric modulated arc-therapy (dpeaa)DE-He213 VMAT (dpeaa)DE-He213 Concomitant radiochemotherapy (dpeaa)DE-He213 Acute toxicity (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Radiation (dpeaa)DE-He213 Ragona, R. verfasserin aut Arcadipane, F. verfasserin aut Mistrangelo, M. verfasserin aut Cassoni, P. verfasserin aut Rondi, N. verfasserin aut Morino, M. verfasserin aut Racca, P. verfasserin aut Ricardi, U. verfasserin aut Enthalten in Revista de oncología Barcelona : Doyma, 2000 19(2016), 1 vom: 01. Apr., Seite 67-75 (DE-627)385985452 (DE-600)2143451-7 1578-195X nnns volume:19 year:2016 number:1 day:01 month:04 pages:67-75 https://dx.doi.org/10.1007/s12094-016-1504-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 19 2016 1 01 04 67-75
allfieldsGer	10.1007/s12094-016-1504-2 doi (DE-627)SPR02426539X (SPR)s12094-016-1504-2-e DE-627 ger DE-627 rakwb eng 610 ASE Franco, P. verfasserin aut Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT. Anal cancer (dpeaa)DE-He213 IMRT (dpeaa)DE-He213 Volumetric modulated arc-therapy (dpeaa)DE-He213 VMAT (dpeaa)DE-He213 Concomitant radiochemotherapy (dpeaa)DE-He213 Acute toxicity (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Radiation (dpeaa)DE-He213 Ragona, R. verfasserin aut Arcadipane, F. verfasserin aut Mistrangelo, M. verfasserin aut Cassoni, P. verfasserin aut Rondi, N. verfasserin aut Morino, M. verfasserin aut Racca, P. verfasserin aut Ricardi, U. verfasserin aut Enthalten in Revista de oncología Barcelona : Doyma, 2000 19(2016), 1 vom: 01. Apr., Seite 67-75 (DE-627)385985452 (DE-600)2143451-7 1578-195X nnns volume:19 year:2016 number:1 day:01 month:04 pages:67-75 https://dx.doi.org/10.1007/s12094-016-1504-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 19 2016 1 01 04 67-75
allfieldsSound	10.1007/s12094-016-1504-2 doi (DE-627)SPR02426539X (SPR)s12094-016-1504-2-e DE-627 ger DE-627 rakwb eng 610 ASE Franco, P. verfasserin aut Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT. Anal cancer (dpeaa)DE-He213 IMRT (dpeaa)DE-He213 Volumetric modulated arc-therapy (dpeaa)DE-He213 VMAT (dpeaa)DE-He213 Concomitant radiochemotherapy (dpeaa)DE-He213 Acute toxicity (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Radiation (dpeaa)DE-He213 Ragona, R. verfasserin aut Arcadipane, F. verfasserin aut Mistrangelo, M. verfasserin aut Cassoni, P. verfasserin aut Rondi, N. verfasserin aut Morino, M. verfasserin aut Racca, P. verfasserin aut Ricardi, U. verfasserin aut Enthalten in Revista de oncología Barcelona : Doyma, 2000 19(2016), 1 vom: 01. Apr., Seite 67-75 (DE-627)385985452 (DE-600)2143451-7 1578-195X nnns volume:19 year:2016 number:1 day:01 month:04 pages:67-75 https://dx.doi.org/10.1007/s12094-016-1504-2 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 AR 19 2016 1 01 04 67-75
language	English
source	Enthalten in Revista de oncología 19(2016), 1 vom: 01. Apr., Seite 67-75 volume:19 year:2016 number:1 day:01 month:04 pages:67-75
sourceStr	Enthalten in Revista de oncología 19(2016), 1 vom: 01. Apr., Seite 67-75 volume:19 year:2016 number:1 day:01 month:04 pages:67-75
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Anal cancer IMRT Volumetric modulated arc-therapy VMAT Concomitant radiochemotherapy Acute toxicity Radiotherapy Radiation
dewey-raw	610
isfreeaccess_bool	false
container_title	Revista de oncología
authorswithroles_txt_mv	Franco, P. @@aut@@ Ragona, R. @@aut@@ Arcadipane, F. @@aut@@ Mistrangelo, M. @@aut@@ Cassoni, P. @@aut@@ Rondi, N. @@aut@@ Morino, M. @@aut@@ Racca, P. @@aut@@ Ricardi, U. @@aut@@
publishDateDaySort_date	2016-04-01T00:00:00Z
hierarchy_top_id	385985452
dewey-sort	3610
id	SPR02426539X
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR02426539X</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519164628.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2016 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s12094-016-1504-2</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR02426539X</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12094-016-1504-2-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Franco, P.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2016</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Anal cancer</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">IMRT</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Volumetric modulated arc-therapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">VMAT</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Concomitant radiochemotherapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Acute toxicity</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Radiotherapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Radiation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ragona, R.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Arcadipane, F.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Mistrangelo, M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cassoni, P.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Rondi, N.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Morino, M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Racca, P.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ricardi, U.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Revista de oncología</subfield><subfield code="d">Barcelona : Doyma, 2000</subfield><subfield code="g">19(2016), 1 vom: 01. Apr., Seite 67-75</subfield><subfield code="w">(DE-627)385985452</subfield><subfield code="w">(DE-600)2143451-7</subfield><subfield code="x">1578-195X</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:19</subfield><subfield code="g">year:2016</subfield><subfield code="g">number:1</subfield><subfield code="g">day:01</subfield><subfield code="g">month:04</subfield><subfield code="g">pages:67-75</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://dx.doi.org/10.1007/s12094-016-1504-2</subfield><subfield code="z">lizenzpflichtig</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_SPRINGER</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_23</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_31</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_60</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_70</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_74</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_90</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_100</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_120</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_152</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_171</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_187</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_224</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_250</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_281</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_370</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_702</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">19</subfield><subfield code="j">2016</subfield><subfield code="e">1</subfield><subfield code="b">01</subfield><subfield code="c">04</subfield><subfield code="h">67-75</subfield></datafield></record></collection>
author	Franco, P.
spellingShingle	Franco, P. ddc 610 misc Anal cancer misc IMRT misc Volumetric modulated arc-therapy misc VMAT misc Concomitant radiochemotherapy misc Acute toxicity misc Radiotherapy misc Radiation Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
authorStr	Franco, P.
ppnlink_with_tag_str_mv	@@773@@(DE-627)385985452
format	electronic Article
dewey-ones	610 - Medicine & health
delete_txt_mv	keep
author_role	aut aut aut aut aut aut aut aut aut
collection	springer
remote_str	true
illustrated	Not Illustrated
issn	1578-195X
topic_title	610 ASE Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer Anal cancer (dpeaa)DE-He213 IMRT (dpeaa)DE-He213 Volumetric modulated arc-therapy (dpeaa)DE-He213 VMAT (dpeaa)DE-He213 Concomitant radiochemotherapy (dpeaa)DE-He213 Acute toxicity (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Radiation (dpeaa)DE-He213
topic	ddc 610 misc Anal cancer misc IMRT misc Volumetric modulated arc-therapy misc VMAT misc Concomitant radiochemotherapy misc Acute toxicity misc Radiotherapy misc Radiation
topic_unstemmed	ddc 610 misc Anal cancer misc IMRT misc Volumetric modulated arc-therapy misc VMAT misc Concomitant radiochemotherapy misc Acute toxicity misc Radiotherapy misc Radiation
topic_browse	ddc 610 misc Anal cancer misc IMRT misc Volumetric modulated arc-therapy misc VMAT misc Concomitant radiochemotherapy misc Acute toxicity misc Radiotherapy misc Radiation
format_facet	Elektronische Aufsätze Aufsätze Elektronische Ressource
format_main_str_mv	Text Zeitschrift/Artikel
carriertype_str_mv	cr
hierarchy_parent_title	Revista de oncología
hierarchy_parent_id	385985452
dewey-tens	610 - Medicine & health
hierarchy_top_title	Revista de oncología
isfreeaccess_txt	false
familylinks_str_mv	(DE-627)385985452 (DE-600)2143451-7
title	Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
ctrlnum	(DE-627)SPR02426539X (SPR)s12094-016-1504-2-e
title_full	Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
author_sort	Franco, P.
journal	Revista de oncología
journalStr	Revista de oncología
lang_code	eng
isOA_bool	false
dewey-hundreds	600 - Technology
recordtype	marc
publishDateSort	2016
contenttype_str_mv	txt
container_start_page	67
author_browse	Franco, P. Ragona, R. Arcadipane, F. Mistrangelo, M. Cassoni, P. Rondi, N. Morino, M. Racca, P. Ricardi, U.
container_volume	19
class	610 ASE
format_se	Elektronische Aufsätze
author-letter	Franco, P.
doi_str_mv	10.1007/s12094-016-1504-2
dewey-full	610
author2-role	verfasserin
title_sort	dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
title_auth	Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
abstract	Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT.
abstractGer	Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT.
abstract_unstemmed	Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT.
collection_details	GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_120 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702
container_issue	1
title_short	Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer
url	https://dx.doi.org/10.1007/s12094-016-1504-2
remote_bool	true
author2	Ragona, R. Arcadipane, F. Mistrangelo, M. Cassoni, P. Rondi, N. Morino, M. Racca, P. Ricardi, U.
author2Str	Ragona, R. Arcadipane, F. Mistrangelo, M. Cassoni, P. Rondi, N. Morino, M. Racca, P. Ricardi, U.
ppnlink	385985452
mediatype_str_mv	c
isOA_txt	false
hochschulschrift_bool	false
doi_str	10.1007/s12094-016-1504-2
up_date	2024-07-04T00:13:35.208Z
_version_	1803605261901889536
fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR02426539X</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519164628.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201006s2016 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s12094-016-1504-2</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR02426539X</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12094-016-1504-2-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Franco, P.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2016</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Purpose This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. Methods 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. Results Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V20 was associated with lower WBC nadir. Increased LSBM-V40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V40 was found. Patients with LSBM-V40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). Conclusions Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium–high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V40 could be used to limit HT.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Anal cancer</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">IMRT</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Volumetric modulated arc-therapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">VMAT</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Concomitant radiochemotherapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Acute toxicity</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Radiotherapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Radiation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ragona, R.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Arcadipane, F.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Mistrangelo, M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Cassoni, P.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Rondi, N.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Morino, M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Racca, P.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ricardi, U.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Revista de oncología</subfield><subfield code="d">Barcelona : Doyma, 2000</subfield><subfield code="g">19(2016), 1 vom: 01. Apr., Seite 67-75</subfield><subfield code="w">(DE-627)385985452</subfield><subfield code="w">(DE-600)2143451-7</subfield><subfield code="x">1578-195X</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:19</subfield><subfield code="g">year:2016</subfield><subfield code="g">number:1</subfield><subfield code="g">day:01</subfield><subfield code="g">month:04</subfield><subfield code="g">pages:67-75</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://dx.doi.org/10.1007/s12094-016-1504-2</subfield><subfield code="z">lizenzpflichtig</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_SPRINGER</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_23</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_31</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_60</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_70</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_74</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_90</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_100</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_120</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_152</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_171</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_187</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_224</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_250</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_281</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_370</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_702</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">19</subfield><subfield code="j">2016</subfield><subfield code="e">1</subfield><subfield code="b">01</subfield><subfield code="c">04</subfield><subfield code="h">67-75</subfield></datafield></record></collection>
score	7.396736

Nicht das Richtige dabei?

Schreiben Sie uns!

Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer

Nicht das Richtige dabei?

Zugang & Verfügbarkeit

Vorhandene Bände

Nicht das Richtige dabei?