Introduction: Concurrent chemoradiation therapy (CCRT) is the standard of care in the management of cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] 2008 Stages IB2-IVA). Apart from the myelotoxic effects of chemotherapy, irradiation of pelvic bone marrow (BM) in the radiation field, can also contribute to hematological toxicity.
Objectives: We examined the relationship of irradiated BM volume and neutropenia in cervical cancer patients undergoing CCRT.
Materials And Methods: This prospective study was conducted in a tertiary cancer center with a longitudinal study design. A total of 43 patients undergoing CCRT for cervical cancer were included. Using auto bone segmentation, the external contour of pelvic bones from L4 vertebral body to ischial tuberosities were delineated as BM. The volume of BM receiving 10, 20, 40, 50 Gy was calculated. Complete blood counts were done weekly to evaluate the neutropenia and were graded according to Common Terminology Criteria for Adverse Events, version 3.0. The risk of developing neutropenia was analyzed using logistic regression.
Results: Twenty-seven patients (62.8%) received 5 cycles of chemotherapy, 14 patients (32.6%) received 4 cycles of chemotherapy and 2 patients (4.7%) received 3 cycles of chemotherapy. Overall, 22 patients (51.2%) experienced acute neutropenia. On multivariate analysis increased BM V50Gy had a statistically significantly odds of developing any grade of neutropenia (odds ratio [OR] =1.43; 95% confidence interval [CI], 1.03-1.97; P = 0.028). When comparing patients receiving BM V40Gy ≥40% with BM V40Gy <40% odds of any grade of neutropenia was increased (OR = 2.03; 95% CI, 0.55-7.42; P = 0.28). Moreover, when comparing patients receiving BM V50Gy ≥15% with BM V50Gy <15% odds of any grade of neutropenia was increased (OR = 2.13; 95% CI, 0.57-7.97; P = 0.26).
Conclusions: High-dose irradiation to the larger volume of BM prevents compensatory hyperplasia which leads to neutropenia in patients undergoing CCRT for cervical cancer.
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http://dx.doi.org/10.4103/jcrt.jcrt_924_21 | DOI Listing |
Cancer Causes Control
January 2025
Division of Health Policy and Management, University of California, Berkeley, Berkeley, CA, USA.
Purpose: Older Black women and women living in areas of low socioeconomic status (SES) diagnosed with cervical cancer (CC) have worse overall survival (OS). The objective was to investigate associations between OS and race/ethnicity and sociodemographic factors in younger (21-64 years) and older women (≥ 65 years) diagnosed with CC using Surveillance, Epidemiology, and End Results Program data.
Methods: This retrospective, population-based cohort study included 39,000 women ≥ 21 years diagnosed with CC diagnosed between 2006 and 2020.
J Sep Sci
January 2025
Key Laboratory of Tropical Medicinal Resource Chemistry of Ministry of Education, Hainan Normal University, Haikou, China.
A comprehensive strategy, including spectroscopic, molecular simulation, proteomics, and bioinformatics techniques, was employed to investigate a novel triazole, 5-(4-methoxyphenyl)-1-phenyl-1H-1,2,3-triazole, its interactions with high-abundance blood proteins, and identification of low-abundance proteins. The binding constants and thermodynamic parameters of the triazole to two high-abundance blood globular proteins, human serum albumin, and human immunoglobulin G (HIgG), were obtained by spectroscopic techniques and computational chemistry. The two-dimensional gel electrophoresis in combination with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was employed to isolate and identify differentially expressed low-abundance proteins in human blood serum samples following exposure to the triazole.
View Article and Find Full Text PDFHealth Promot Pract
January 2025
The University of Utah College of Nursing, Salt Lake City, UT, USA.
Cervical cancer is the leading cause of cancer-related death among Latin American women, including Guatemalans. This is troubling, given we have a vaccine, screening tool, and treatment for this preventable disease. Human papillomavirus (HPV) causes most cervical cancer.
View Article and Find Full Text PDFCurr Med Chem
January 2025
Department of Pharmaceutical Quality Assurance, SVKM Institute of Pharmacy, Dhule, 424001, India.
Cervical cancer remains a significant global health concern, making it essential to investigate new treatment options continuously. This page provides an overview of the latest advancements and best practices in detection and intervention, including Pap smears, colposcopy, biopsy, immunotherapy, targeted therapies, chemotherapy, radiation therapy, and surgery. Surgical techniques such as radical hysterectomy and minimally invasive procedures have advanced to enhance patient outcomes and quality of life.
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