Hematologic toxicity and bone marrow-sparing strategies in chemoradiation for locally advanced cervical cancer: A Systematic Review
The standard treatment for locally advanced cervical cancer typically includes concomitant chemoradiation, a regimen known to induce severe hematologic toxicity (HT). Particularly, pelvic bone marrow dose exposure has been identified as a contributing factor to this hematologic toxicity. Chemotherap...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
11 Mai 2024
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| In: |
Cancers
Year: 2024, Volume: 16, Issue: 10, Pages: 1-21 |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers16101842 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/cancers16101842 Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/16/10/1842 
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| Author Notes: | Dinah Konnerth, Aurelie Gaasch, Annemarie Zinn, Paul Rogowski, Maya Rottler, Franziska Walter, Johannes Knoth, Alina Sturdza, Jan Oelmann, Freba Grawe, Raphael Bodensohn, Claus Belka and Stefanie Corradini |
| Summary: | The standard treatment for locally advanced cervical cancer typically includes concomitant chemoradiation, a regimen known to induce severe hematologic toxicity (HT). Particularly, pelvic bone marrow dose exposure has been identified as a contributing factor to this hematologic toxicity. Chemotherapy further increases bone marrow suppression, often necessitating treatment interruptions or dose reductions. A systematic search for original articles published between 1 January 2006 and 7 January 2024 that reported on chemoradiotherapy for locally advanced cervical cancer and hematologic toxicities was conducted. Twenty-four articles comprising 1539 patients were included in the final analysis. HT of grade 2 and higher was observed across all studies and frequently exceeded 50%. When correlating active pelvic bone marrow and HT, significant correlations were found for volumes between 10 and 45 Gy and HT of grade 3 and higher. Several dose recommendations for pelvic bone and pelvic bone marrow sparing to reduce HT were established, including V10 < 90-95%, V20 < 65-86.6% and V40 < 22.8-40%. Applying dose constraints to the pelvic bone/bone marrow is a promising approach for reducing HT, and thus reliable implementation of therapy. However, prospective randomized controlled trials are needed to define precise dose constraints and optimize clinical strategies. |
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| Item Description: | Gesehen am 11.12.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers16101842 |