Preoperative chemoradiation-induced hematological toxicity and related vertebral dosimetry evaluations in patients with locally advanced gastric cancer: data from a phase III clinical trial

作者：Ji-Jin Wang, S. Han, Li Zhang, Ming Jing, Wen-jing Xu, Hengwen Sun, Zhiwei Zhou, Yujing Zhang · 发表于：Radiation Oncology · 年份：2023 · DOI：10.1186/s13014-023-02269-6 · 被引用次数：6 · 研究领域：Management of metastatic bone disease、Gastric Cancer Management and Outcomes、Head and Neck Cancer Studies

Abstract Background To explore the hematological toxicity (HT) induced by neoadjuvant chemoradiotherapy (nCRT) compared with neoadjuvant chemotherapy (nCT) and to identify the appropriate vertebral body (VB) dosimetric parameters for predicting HT in patients with locally advanced gastric cancer (GC). Methods In the phase III study, 302 patients with GC from an ongoing multi-center randomized clinical trial (NCT 01815853) were included. Patients from two major centers were grouped into training and external validation cohorts. The nCT group received three cycles of XELOX chemotherapy, while the nCRT received the same dose-reduced chemotherapy plus 45 Gy radiotherapy. The complete blood counts at baseline, during neoadjuvant treatment, and in the preoperative period were compared between the nCT and nCRT groups. The VB was retrospectively contoured and the dose-volume parameters were extracted in the nCRT group. Patients’ clinical characteristics, VB dosimetric parameters, and HTs were statistically analyzed. Instances of HT were graded according to the Common Terminology Criteria for Adverse Events v5.0 (CTCAE v5.0). The receiver operating characteristic (ROC) curves were generated to identify the optimal cut-off points for dosimetric variables and verify the prediction efficiency of the dosimetric index in both training and external validation cohorts. Results In the training cohort, 27.4% Grade 3 + HTs were noted in the nCRT group and 16.2% in the nCT group ( P = 0.042). A ...