NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy
Purpose: Our purpose was to determine and model the dose-response relations of different parts of the pelvis regarding the endpoint of hematocrit level drop after pelvic radiation therapy (RT). Methods and Materials: Two hundred and twenty-one patients treated with RT for prostate adenocarcinoma bet...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S245210942300221X |
| _version_ | 1797356060505276416 |
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| author | Panos Papanikolaou, MD Gregory Swanson, MD Sotirios Stathakis, PhD Panayiotis Mavroidis, PhD |
| author_facet | Panos Papanikolaou, MD Gregory Swanson, MD Sotirios Stathakis, PhD Panayiotis Mavroidis, PhD |
| author_sort | Panos Papanikolaou, MD |
| collection | DOAJ |
| description | Purpose: Our purpose was to determine and model the dose-response relations of different parts of the pelvis regarding the endpoint of hematocrit level drop after pelvic radiation therapy (RT). Methods and Materials: Two hundred and twenty-one patients treated with RT for prostate adenocarcinoma between 2014 and 2016 were included. All patients had complete blood counts collected at baseline and 3 months post-RT. The net difference of hematocrit level post-RT versus baseline was calculated, and the level of the 15th percentiles defined the thresholds of response in each case. The doses to 8 different pelvic structures were derived and fitted to the hematocrit levels using the relative seriality normal tissue complication probability model and the biologically equivalent uniform dose (D=). Results: Pelvic structures that correlated with significant decreases in hematocrit were the os coxae bilaterally superior to the acetabulum (OCUB), the total os coxae bilaterally, and the bone volume of the whole pelvis. The structure showing the highest correlation was OCUB with a maximum area under the curve (AUC) of 0.74. For V20 Gy < 30% the odds ratio was 9.8 with 95% CI of 2.9 to 32.9. For mean dose (Dmean) to OCUB, an AUC of 0.73 was observed where the dose threshold was 23 Gy and the odds ratio was 2.7 and 95% CI 1.3 to 5.6. The values for the D50, γ, and s parameters of the relative seriality model were 26.9 Gy (25.9-27.9), 1.3 (1.2-2.2), and 0.12 (0.10-0.83), respectively. The AUC of D= was 0.73 and patients with D= to OCUB ≥ 27 Gy had 8.2 times higher rate of significant hematocrit drop versus <27 Gy. Conclusions: These findings confirm the association of radiation-induced damage to pelvic bone marrow with a drop in hematocrit. A threshold of V20 Gy < 30%, Dmean < 23 Gy, or D= < 27 Gy to OCUB may significantly reduce the risk for this endpoint. |
| first_indexed | 2024-03-08T14:21:06Z |
| format | Article |
| id | doaj.art-66853af6491249c08abf95867fa313a1 |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-03-08T14:21:06Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-66853af6491249c08abf95867fa313a12024-01-14T05:39:39ZengElsevierAdvances in Radiation Oncology2452-10942024-03-0193101393NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation TherapyPanos Papanikolaou, MD0Gregory Swanson, MD1Sotirios Stathakis, PhD2Panayiotis Mavroidis, PhD3Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Corresponding author: Panos Papanikolaou, MDDepartment of Radiation Oncology, Baylor Scott & White Health, Temple, TexasDepartment of Physics, Mary Bird Perkins Cancer Center, Baton Rouge, LouisianaDepartment of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaPurpose: Our purpose was to determine and model the dose-response relations of different parts of the pelvis regarding the endpoint of hematocrit level drop after pelvic radiation therapy (RT). Methods and Materials: Two hundred and twenty-one patients treated with RT for prostate adenocarcinoma between 2014 and 2016 were included. All patients had complete blood counts collected at baseline and 3 months post-RT. The net difference of hematocrit level post-RT versus baseline was calculated, and the level of the 15th percentiles defined the thresholds of response in each case. The doses to 8 different pelvic structures were derived and fitted to the hematocrit levels using the relative seriality normal tissue complication probability model and the biologically equivalent uniform dose (D=). Results: Pelvic structures that correlated with significant decreases in hematocrit were the os coxae bilaterally superior to the acetabulum (OCUB), the total os coxae bilaterally, and the bone volume of the whole pelvis. The structure showing the highest correlation was OCUB with a maximum area under the curve (AUC) of 0.74. For V20 Gy < 30% the odds ratio was 9.8 with 95% CI of 2.9 to 32.9. For mean dose (Dmean) to OCUB, an AUC of 0.73 was observed where the dose threshold was 23 Gy and the odds ratio was 2.7 and 95% CI 1.3 to 5.6. The values for the D50, γ, and s parameters of the relative seriality model were 26.9 Gy (25.9-27.9), 1.3 (1.2-2.2), and 0.12 (0.10-0.83), respectively. The AUC of D= was 0.73 and patients with D= to OCUB ≥ 27 Gy had 8.2 times higher rate of significant hematocrit drop versus <27 Gy. Conclusions: These findings confirm the association of radiation-induced damage to pelvic bone marrow with a drop in hematocrit. A threshold of V20 Gy < 30%, Dmean < 23 Gy, or D= < 27 Gy to OCUB may significantly reduce the risk for this endpoint.http://www.sciencedirect.com/science/article/pii/S245210942300221X |
| spellingShingle | Panos Papanikolaou, MD Gregory Swanson, MD Sotirios Stathakis, PhD Panayiotis Mavroidis, PhD NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy Advances in Radiation Oncology |
| title | NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy |
| title_full | NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy |
| title_fullStr | NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy |
| title_full_unstemmed | NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy |
| title_short | NTCP Modeling and Dose-Volume Correlations of Significant Hematocrit Drop 3 Months After Prostate Radiation Therapy |
| title_sort | ntcp modeling and dose volume correlations of significant hematocrit drop 3 months after prostate radiation therapy |
| url | http://www.sciencedirect.com/science/article/pii/S245210942300221X |
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