Abstract:
Objective To identify the relationships between irradiated dosimetric parameters of bone marrow (BM) and hematologic toxicities in locally advanced adenocarcinoma of the esophagogastric junction (AEG) patients treated with preoperative chemoradiotherapy (CRT).
Methods We retrospectively analyzed the clinical data of 60 AEG patients treated with concurrent oxaliplatin-capecitabine and radiotherapy in the Fourth Hospital of Hebei Medical University from Dec. 2013 to May 2016. The relationship between irradiated dosimetric parameters of bone marrow (BM) and hematologic toxicity (HT) was evaluated.
Results Among 60 patients with AEG, 55% (33/60) developed grade ≥2 acute HT, 11.67% (7/60) developed neutropenia, 1.67% (1/60) developed anemia and 33.33% (20/60) developed thrombocytopenia. Univariate Logistic regression analysis showed that ribs V30 (P=0.034), ribsV35 (P=0.008), ribsV40 (P=0.018), ribsV45 (P=0.016) and BM-T V25 (P=0.026) were associated with increased risk of grade ≥2 leukopenia; ribsV30(P=0.033) was associated with increased risk of grade ≥2 thrombocytopenia; sternumV20 (P=0.041), sternumV25 (P=0.019), sternumV35 (P=0.034) and BM-T V25 (P=0.035) were associated with increased risk of grade ≥2 HT. Multivariate Logistic regression analysis demonstrated that ribsV35 and BM-T V25 were associated with increased risk of grade ≥2 leukopenia, and BM-T V25 was associated with increased risk of grade ≥2 HT.
Conclusion Reducing the irradiated dosage of bone marrow may decrease the risk of grade ≥2 hematologic toxicity in locally advanced adenocarcinoma of the esophagogastric junction patients treated with preoperative concurrent chemoradiotherapy.
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