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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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Hauptverfasser: Konnerth, Dinah (VerfasserIn) , Gaasch, Aurelie (VerfasserIn) , Zinn, Annemarie (VerfasserIn) , Rogowski, Paul (VerfasserIn) , Rottler, Maya (VerfasserIn) , Walter, Franziska (VerfasserIn) , Knoth, Johannes (VerfasserIn) , Sturdza, Alina (VerfasserIn) , Oelmann, Jan (VerfasserIn) , Grawe, Freba (VerfasserIn) , Bodensohn, Raphael (VerfasserIn) , Belka, Claus (VerfasserIn) , Corradini, Stefanie (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 11 Mai 2024
In: Cancers
Year: 2024, Jahrgang: 16, Heft: 10, Pages: 1-21
ISSN:2072-6694
DOI:10.3390/cancers16101842
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/cancers16101842
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/16/10/1842
Volltext
Verfasserangaben: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
Beschreibung
Zusammenfassung: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.
Beschreibung:Gesehen am 11.12.2024
Beschreibung:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers16101842

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