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The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy

BACKGROUND: The purpose of the current study was to evaluate whether radiation dose‐volume metrics to technetium‐99m ((99m)Tc) sulfur colloid single‐photon emission tomography (SPET)‐defined active bone marrow (ABM) subregions can more accurately predict acute hematologic toxicity in locally advance...

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Autores principales: Wang, Shan‐Bing, Liu, Jia‐Pei, Lei, Kai‐Jian, Jia, Yu‐Ming, Xu, Yan, Rong, Jin‐Feng, Wang, Chun‐Xiu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885884/
https://www.ncbi.nlm.nih.gov/pubmed/31621208
http://dx.doi.org/10.1002/cam4.2601
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author Wang, Shan‐Bing
Liu, Jia‐Pei
Lei, Kai‐Jian
Jia, Yu‐Ming
Xu, Yan
Rong, Jin‐Feng
Wang, Chun‐Xiu
author_facet Wang, Shan‐Bing
Liu, Jia‐Pei
Lei, Kai‐Jian
Jia, Yu‐Ming
Xu, Yan
Rong, Jin‐Feng
Wang, Chun‐Xiu
author_sort Wang, Shan‐Bing
collection PubMed
description BACKGROUND: The purpose of the current study was to evaluate whether radiation dose‐volume metrics to technetium‐99m ((99m)Tc) sulfur colloid single‐photon emission tomography (SPET)‐defined active bone marrow (ABM) subregions can more accurately predict acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy than conventional dosimetric parameters. METHODS AND MATERIALS: Thirty‐nine patients with stage IB2‐III cervical cancer who underwent (99m)Tc sulfur colloid SPET imaging before treatment with cisplatin‐based chemoradiation between January 2017 and March 2018 were analyzed. The total bone marrow (TBM) volume was defined as the external contours of all bones within the vertebral bodies from L4 to the coccyx, the pelvic bones, and the proximal femoral heads. The ABM volume was defined by SPET as the subregion of TBM with a nuclide uptake value greater than or equal to the mean total body nuclide uptake value. Student's t test was used to test for statistical significance between TBM and ABM dose‐volume metrics. Receiver operating characteristic (ROC) curves were generated to compare the predictors of grade 3 or higher (grade 3+) hematologic toxicity. RESULTS: The mean ABM‐V40 (23.22% ± 7.65%) and ABM‐V30 (45.28% ± 9.20%) were significantly lower than the mean TBM‐V40 (33.06% ± 6.72%) and TBM‐V30 (53.08% ± 7.77%), respectively (t = 5.78, P = .001) (t = 4.13, P = .001). The ABM volume (<387.5 cm(3), AUC = 0.928, P = .001), ABM‐V30 (>46.5%, AUC = 0.875, P = .001), and ABM‐V40 (>23.5%, AUC = 0.858, P = .001) can predict the occurrence of grade 3+ hematologic toxicity. Among patients with an ABM volume < 387.5 cm(3), 16/19 (84.2%) had grade 3+ hematologic toxicity compared to 3/20 (15%) with an ABM volume > 387.5 cm(3). CONCLUSIONS: The ABM volume (<387.5 cm(3)) may be a better predictor of hematologic toxicity than conventional dose‐volume metrics, but this finding needs to be further evaluated.
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spelling pubmed-68858842019-12-09 The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy Wang, Shan‐Bing Liu, Jia‐Pei Lei, Kai‐Jian Jia, Yu‐Ming Xu, Yan Rong, Jin‐Feng Wang, Chun‐Xiu Cancer Med Clinical Cancer Research BACKGROUND: The purpose of the current study was to evaluate whether radiation dose‐volume metrics to technetium‐99m ((99m)Tc) sulfur colloid single‐photon emission tomography (SPET)‐defined active bone marrow (ABM) subregions can more accurately predict acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy than conventional dosimetric parameters. METHODS AND MATERIALS: Thirty‐nine patients with stage IB2‐III cervical cancer who underwent (99m)Tc sulfur colloid SPET imaging before treatment with cisplatin‐based chemoradiation between January 2017 and March 2018 were analyzed. The total bone marrow (TBM) volume was defined as the external contours of all bones within the vertebral bodies from L4 to the coccyx, the pelvic bones, and the proximal femoral heads. The ABM volume was defined by SPET as the subregion of TBM with a nuclide uptake value greater than or equal to the mean total body nuclide uptake value. Student's t test was used to test for statistical significance between TBM and ABM dose‐volume metrics. Receiver operating characteristic (ROC) curves were generated to compare the predictors of grade 3 or higher (grade 3+) hematologic toxicity. RESULTS: The mean ABM‐V40 (23.22% ± 7.65%) and ABM‐V30 (45.28% ± 9.20%) were significantly lower than the mean TBM‐V40 (33.06% ± 6.72%) and TBM‐V30 (53.08% ± 7.77%), respectively (t = 5.78, P = .001) (t = 4.13, P = .001). The ABM volume (<387.5 cm(3), AUC = 0.928, P = .001), ABM‐V30 (>46.5%, AUC = 0.875, P = .001), and ABM‐V40 (>23.5%, AUC = 0.858, P = .001) can predict the occurrence of grade 3+ hematologic toxicity. Among patients with an ABM volume < 387.5 cm(3), 16/19 (84.2%) had grade 3+ hematologic toxicity compared to 3/20 (15%) with an ABM volume > 387.5 cm(3). CONCLUSIONS: The ABM volume (<387.5 cm(3)) may be a better predictor of hematologic toxicity than conventional dose‐volume metrics, but this finding needs to be further evaluated. John Wiley and Sons Inc. 2019-10-16 /pmc/articles/PMC6885884/ /pubmed/31621208 http://dx.doi.org/10.1002/cam4.2601 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Wang, Shan‐Bing
Liu, Jia‐Pei
Lei, Kai‐Jian
Jia, Yu‐Ming
Xu, Yan
Rong, Jin‐Feng
Wang, Chun‐Xiu
The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
title The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
title_full The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
title_fullStr The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
title_full_unstemmed The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
title_short The volume of (99m)Tc sulfur colloid SPET‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
title_sort volume of (99m)tc sulfur colloid spet‐defined active bone marrow can predict grade 3 or higher acute hematologic toxicity in locally advanced cervical cancer patients who receive chemoradiotherapy
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885884/
https://www.ncbi.nlm.nih.gov/pubmed/31621208
http://dx.doi.org/10.1002/cam4.2601
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