Introduction: Hematologic toxicity (HT), particularly leukopenia, is a common side-effect of oncologic treatments for pelvic malignancies. Pelvic nodal radiotherapy (PNRT) has been associated with HT development mainly through incidental bone marrow (BM) irradiation; however, several questions remain about the clinical impact of radiotherapy-related HT. Herein, we perform a systematic review of the available evidence on PNRT and HT. Materials and Methods: A comprehensive systematic literature search was performed through EMBASE. Hand searching and clinicaltrials.gov were also used. Results: While BM-related dose-volume parameters and BM-sparing techniques have been more thoroughly investigated in pelvic malignancies such as cervical, anal, and rectal cancers, the importance of BM as an organ-at-risk has received less attention in prostate cancer treatment. Conclusions: We examined the available evidence regarding the impact of PNRT on HT, with a focus on prostate cancer treatment. We suggest that BM should be regarded as an organ-at-risk for patients undergoing PNRT.

The Impact of Pelvic Nodal Radiotherapy on Hematologic Toxicity: A Systematic Review with Focus on Leukopenia, Lymphopenia and Future Perspectives in Prostate Cancer Treatment

Iorio G. C.;Ricardi U.;
2021

Abstract

Introduction: Hematologic toxicity (HT), particularly leukopenia, is a common side-effect of oncologic treatments for pelvic malignancies. Pelvic nodal radiotherapy (PNRT) has been associated with HT development mainly through incidental bone marrow (BM) irradiation; however, several questions remain about the clinical impact of radiotherapy-related HT. Herein, we perform a systematic review of the available evidence on PNRT and HT. Materials and Methods: A comprehensive systematic literature search was performed through EMBASE. Hand searching and clinicaltrials.gov were also used. Results: While BM-related dose-volume parameters and BM-sparing techniques have been more thoroughly investigated in pelvic malignancies such as cervical, anal, and rectal cancers, the importance of BM as an organ-at-risk has received less attention in prostate cancer treatment. Conclusions: We examined the available evidence regarding the impact of PNRT on HT, with a focus on prostate cancer treatment. We suggest that BM should be regarded as an organ-at-risk for patients undergoing PNRT.
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anal cancer; bone marrow - BM; cervical cancer; hematologic toxicity - HT; leukopenia; lymphopenia; pelvic nodal radiotherapy - PNRT; prostate cancer; Humans; Male; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Leukopenia; Lymphopenia; Prostatic Neoplasms; Radiotherapy, Intensity-Modulated
Iorio G.C.; Spieler B.O.; Ricardi U.; Dal Pra A.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1846340
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