Leukotoxicity after moderately Hypofractionated radiotherapy versus conventionally fractionated dose escalated radiotherapy for localized prostate Cancer: a secondary analysis from a randomized study.
Conventional radiotherapy
Hypofractionated radiotherapy
Leukotoxicity
Localized prostate cancer
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
30 Jan 2019
30 Jan 2019
Historique:
received:
04
10
2018
accepted:
20
01
2019
entrez:
1
2
2019
pubmed:
1
2
2019
medline:
14
3
2019
Statut:
epublish
Résumé
To compare WBC counts during treatment of localized prostate cancer with either conventionally fractionated (CF) or moderately hypofractionated (HYPO) radiotherapy. Weekly blood test results were extracted from the charts of patients treated within a phase III study comparing HYPO to CF. In order to compare WBC counts at the same nominal dose in both arms and thus to tease out the effect of fractionation, for each recorded WBC value the corresponding cumulative total dose was extracted as well. WBC counts were binned according to percentiles of the delivered dose and three dose levels were identified at median doses of 16, 34.1 and 52 Gy, respectively. A General Linear Model based on mixed design Analysis Of Variance (ANOVA) was used to test variation of WBC counts between the two treatment arms. Out of 168 randomized patients, 140 (83.3%) had at least one observation for each one of the selected dose levels and were included in the analysis. Mean counts were lower in the CF than the HYPO arm at all selected dose levels, reaching a statistically significant difference at dose level #3 (5397/mm This secondary analysis of a phase III study shows that dose fractionation is correlated to WBC drop during treatment of localized prostate cancer, favoring HYPO over CF.
Sections du résumé
BACKGROUND
BACKGROUND
To compare WBC counts during treatment of localized prostate cancer with either conventionally fractionated (CF) or moderately hypofractionated (HYPO) radiotherapy.
METHODS
METHODS
Weekly blood test results were extracted from the charts of patients treated within a phase III study comparing HYPO to CF. In order to compare WBC counts at the same nominal dose in both arms and thus to tease out the effect of fractionation, for each recorded WBC value the corresponding cumulative total dose was extracted as well. WBC counts were binned according to percentiles of the delivered dose and three dose levels were identified at median doses of 16, 34.1 and 52 Gy, respectively. A General Linear Model based on mixed design Analysis Of Variance (ANOVA) was used to test variation of WBC counts between the two treatment arms.
RESULTS
RESULTS
Out of 168 randomized patients, 140 (83.3%) had at least one observation for each one of the selected dose levels and were included in the analysis. Mean counts were lower in the CF than the HYPO arm at all selected dose levels, reaching a statistically significant difference at dose level #3 (5397/mm
CONCLUSION
CONCLUSIONS
This secondary analysis of a phase III study shows that dose fractionation is correlated to WBC drop during treatment of localized prostate cancer, favoring HYPO over CF.
Identifiants
pubmed: 30700317
doi: 10.1186/s13014-019-1223-2
pii: 10.1186/s13014-019-1223-2
pmc: PMC6352380
doi:
Types de publication
Clinical Trial, Phase III
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
23Références
Int J Radiat Oncol Biol Phys. 1999 May 1;44(2):317-21
pubmed: 10760425
Int J Radiat Oncol Biol Phys. 2001 Jun 1;50(2):465-72
pubmed: 11380235
Blood. 1963 May;21:605-19
pubmed: 13949415
Nat Immunol. 2004 Feb;5(2):133-9
pubmed: 14749784
J Biol Regul Homeost Agents. 2005 Jul-Dec;19(3-4):153-8
pubmed: 16602631
Lymphat Res Biol. 2008;6(2):77-83
pubmed: 18564922
Radiology. 1948 Sep;51(3):400-13
pubmed: 18882273
Cancer Res. 2009 Jul 1;69(13):5383-91
pubmed: 19549917
Int J Radiat Oncol Biol Phys. 2010 Sep 1;78(1):11-8
pubmed: 20047800
Cancer Radiother. 2010 Jul;14(4-5):392-404
pubmed: 20598617
Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):235-42
pubmed: 22104358
Annu Rev Immunol. 2012;30:69-94
pubmed: 22149932
Cancer Invest. 2012 Oct;30(8):571-6
pubmed: 22812722
Cancer Invest. 2013 Feb;31(2):140-4
pubmed: 23362951
Int J Radiat Oncol Biol Phys. 2013 May 1;86(1):83-90
pubmed: 23582248
Am J Clin Oncol. 2015 Jun;38(3):259-65
pubmed: 23648440
Future Oncol. 2014 Apr;10(5):835-43
pubmed: 24799064
Radiother Oncol. 2014 Oct;113(1):29-34
pubmed: 25304718
Clin Genitourin Cancer. 2015 Feb;13(1):1-9
pubmed: 25450032
J Natl Compr Canc Netw. 2015 Oct;13(10):1225-31
pubmed: 26483062
Gynecol Oncol. 2016 Jan;140(1):76-82
pubmed: 26571200
Radiother Oncol. 2016 Jan;118(1):79-84
pubmed: 26702990
Oncotarget. 2016 May 3;7(18):26422-35
pubmed: 27029063
J Clin Oncol. 2016 Jul 10;34(20):2325-32
pubmed: 27044935
Int J Radiat Oncol Biol Phys. 2016 Jun 1;95(2):690-5
pubmed: 27131081
Cancer. 1978 Jan;41(1):108-11
pubmed: 272224
Lancet Oncol. 2016 Aug;17(8):1047-1060
pubmed: 27339115
J Clin Oncol. 2017 Jun 10;35(17):1884-1890
pubmed: 28296582
Strahlenther Onkol. 2017 Aug;193(8):648-655
pubmed: 28500490
Clin Transl Oncol. 2018 Sep;20(9):1219-1225
pubmed: 29536332
Int J Radiat Oncol Biol Phys. 1987 Jul;13(7):1065-9
pubmed: 3298176
Indian J Med Res. 1986 Mar;83:298-300
pubmed: 3733187
J Clin Pathol Suppl (R Coll Pathol). 1979;13:63-9
pubmed: 391827
Cancer. 1985 May 1;55(9 Suppl):2086-95
pubmed: 3919923
Transplant Proc. 1974 Dec;6(4 Suppl 1):59-65
pubmed: 4155159
Klin Wochenschr. 1974 Jun 1;52(11):511-5
pubmed: 4853392
Am J Roentgenol Radium Ther Nucl Med. 1966 Jan;96(1):183-90
pubmed: 5900876
Radiat Res. 1982 Jan;89(1):38-52
pubmed: 7038741
Transfusion. 1981 Jul-Aug;21(4):419-26
pubmed: 7268866
Int J Radiat Oncol Biol Phys. 1995 Oct 15;33(3):617-17
pubmed: 7558950
Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1319-39
pubmed: 7713791
Lymphology. 1975 Sep;8(3):69-74
pubmed: 811930
Mil Med. 1976 Jun;141(6):390-1
pubmed: 819864