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Impact of hematologic toxicities during concurrent chemoradiation for cervical cancer.
Shi, Feiya; Yoder, Alison K; Mach, Claire; Dalwadi, Shraddha; Anderson, Matthew L; Hall, Tracilyn R; Ludwig, Michelle S.
Afiliação
  • Shi F; Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA.
  • Yoder AK; Department of Radiation Oncology, University of Texas Health Science Center at Houston McGovern School of Medicine, Houston, TX, USA.
  • Mach C; Department of Radiation Oncology, Department of Obstetrics and Gynecology, Houston, TX, USA.
  • Dalwadi S; Department of Radiation Oncology, Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA.
  • Anderson ML; Department of Radiation Oncology, Division of Gynecologic Oncology, Morsani College of Medicine, University of South Florida/Moffitt Cancer Center, Tempa, FL, USA.
  • Hall TR; Department of Radiation Oncology, Department of Obstetrics and Gynecology, Houston, TX, USA.
  • Ludwig MS; Department of Radiation Oncology, Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA.
Obstet Gynecol Sci ; 65(2): 176-187, 2022 Mar.
Article em En | MEDLINE | ID: mdl-35189679
OBJECTIVE: To evaluate the prognostic significance of hematological toxicities during cervical cancer treatment. METHODS: Patients treated for cervical carcinoma with definitive chemoradiation were identified. Toxicities were assessed during weeks 1 to 6 of concurrent external beam radiation and chemotherapy. Outcomes were analyzed using Cox regression analysis. RESULTS: One hundred twenty-one patients with Federation of Gynecology and Obstetrics stage I-III disease were eligible for analysis. Median age at diagnosis was 45 years (interquartile range, 40-52) with median follow-up time of 34 months (95% confidence interval, 30.8-37.2). All patients experienced some grade of hematologic toxicity. The most common grade 3+ toxicities were low absolute lymphocyte count (n=115, 95%), low white blood cell count (n=21, 17%), and anemia (n=11, 9%). The most common grade 4 toxicity was lymphopenia, experienced by 36% of patients (n=44). Grade 4 lymphopenia was associated with reduced overall survival (hazard ratio [HR], 4.5; P=0.005), progression-free survival (HR, 3.4; P=0.001), and local control (HR, 4.1; P=0.047). Anemia grade 3, 4 was also associated with reduced overall survival (HR, 4.1; P=0.014). After controlling for disease and treatment variables, grade 4 lymphopenia remained significantly associated with reduced overall survival (HR, 9.85; P=0.007). The association with grade 4 lymphopenia only remained significant in women of Hispanic ethnicity. CONCLUSION: Severe lymphopenia was associated with reduced overall survival and progression-free survival in Hispanic women undergoing definitive chemoradiation for cervical cancer, but not associated with outcomes in non-Hispanic women.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2022 Tipo de documento: Article