Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer
BackgroundThe aim of this article was to establish the clinical prognostic models and identify the predictive radiation dosimetric parameters for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer.MethodsIn this retrospective cohort study, patients with rectal adenocarcinoma unde...
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| Format: | Article |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1289824/full |
| _version_ | 1797368049671602176 |
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| author | Yue Teng Dapeng Ma Yan Yan Jianhao Geng Zhiyan Liu Xianggao Zhu Shuai Li Yangzi Zhang Hongzhi Wang Yong Cai Haizhen Yue Yongheng Li Weihu Wang |
| author_facet | Yue Teng Dapeng Ma Yan Yan Jianhao Geng Zhiyan Liu Xianggao Zhu Shuai Li Yangzi Zhang Hongzhi Wang Yong Cai Haizhen Yue Yongheng Li Weihu Wang |
| author_sort | Yue Teng |
| collection | DOAJ |
| description | BackgroundThe aim of this article was to establish the clinical prognostic models and identify the predictive radiation dosimetric parameters for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer.MethodsIn this retrospective cohort study, patients with rectal adenocarcinoma undergoing concurrent long-term chemoradiotherapy were included. The primary outcome of interest was grade 2 or higher (2+) thrombocytopenia (platelet(PLT) count <75,000/μL). Secondary outcomes included: grade 1 or higher thrombocytopenia (PLT count<100,000/μL) and the PLT count during chemoradiotherapy and its nadir. The risk prediction model was developed by logistic regression to identify clinical predictors of 2+ thrombocytopenia. Univariate linear regression models were used to test correlations between radiation dosimetric parameters and the absolute PLT count at nadirs.ResultsThis retrospective cohort comprised 238 patients. Fifty-four (22.6%) patients developed thrombocytopenia during concurrent chemoradiotherapy, while 15 (6.3%) patients developed 2+ thrombocytopenia. Four independently associated risk factors, including age, Alb level, PLT count, and chemotherapy regimen, were included in the final model and used to form a 2+ thrombocytopenia probability estimation nomogram. The C‐index was 0.87 (95% CI: 0.78–0.96). The calibration plot showed a moderate agreement, and the Brier score was 0.047 (95% CI: 0.025–0.070). The total absolute volume of bone marrow irradiated by 5 Gy, 10 Gy and 15 Gy of radiation (BM-V5ab, BM-V10ab, BM-V15ab), calculated by the volume of bone marrow multiplied by the corresponding Vx, were identified as new predictors. The nadir of PLT was found to be negatively correlated with BM-V5ab (β = -0.062, P =0.030), BM-V10ab (β = -0.065, P =0.030) and BM-V15ab (β = -0.064, P =0.042).ConclusionThe occurrence of 2+ thrombocytopenia during concurrent chemoradiotherapy for rectal cancer can be predicted by the patient’s baseline status and chemoradiotherapy regimen, and low dose irradiation of bone marrow can affect the level of platelets during the treatment. |
| first_indexed | 2024-03-08T17:26:51Z |
| format | Article |
| id | doaj.art-a0756b8f61da4ceaa3d996f34eeea94b |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-08T17:26:51Z |
| publishDate | 2024-01-01 |
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| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a0756b8f61da4ceaa3d996f34eeea94b2024-01-02T18:47:56ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-01-011310.3389/fonc.2023.12898241289824Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancerYue Teng0Dapeng Ma1Yan Yan2Jianhao Geng3Zhiyan Liu4Xianggao Zhu5Shuai Li6Yangzi Zhang7Hongzhi Wang8Yong Cai9Haizhen Yue10Yongheng Li11Weihu Wang12Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Endoscopy Center, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, ChinaBackgroundThe aim of this article was to establish the clinical prognostic models and identify the predictive radiation dosimetric parameters for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer.MethodsIn this retrospective cohort study, patients with rectal adenocarcinoma undergoing concurrent long-term chemoradiotherapy were included. The primary outcome of interest was grade 2 or higher (2+) thrombocytopenia (platelet(PLT) count <75,000/μL). Secondary outcomes included: grade 1 or higher thrombocytopenia (PLT count<100,000/μL) and the PLT count during chemoradiotherapy and its nadir. The risk prediction model was developed by logistic regression to identify clinical predictors of 2+ thrombocytopenia. Univariate linear regression models were used to test correlations between radiation dosimetric parameters and the absolute PLT count at nadirs.ResultsThis retrospective cohort comprised 238 patients. Fifty-four (22.6%) patients developed thrombocytopenia during concurrent chemoradiotherapy, while 15 (6.3%) patients developed 2+ thrombocytopenia. Four independently associated risk factors, including age, Alb level, PLT count, and chemotherapy regimen, were included in the final model and used to form a 2+ thrombocytopenia probability estimation nomogram. The C‐index was 0.87 (95% CI: 0.78–0.96). The calibration plot showed a moderate agreement, and the Brier score was 0.047 (95% CI: 0.025–0.070). The total absolute volume of bone marrow irradiated by 5 Gy, 10 Gy and 15 Gy of radiation (BM-V5ab, BM-V10ab, BM-V15ab), calculated by the volume of bone marrow multiplied by the corresponding Vx, were identified as new predictors. The nadir of PLT was found to be negatively correlated with BM-V5ab (β = -0.062, P =0.030), BM-V10ab (β = -0.065, P =0.030) and BM-V15ab (β = -0.064, P =0.042).ConclusionThe occurrence of 2+ thrombocytopenia during concurrent chemoradiotherapy for rectal cancer can be predicted by the patient’s baseline status and chemoradiotherapy regimen, and low dose irradiation of bone marrow can affect the level of platelets during the treatment.https://www.frontiersin.org/articles/10.3389/fonc.2023.1289824/fullrectal cancerthrombocytopeniaconcurrent chemoradiotherapyrisk factorsclinical predictorsradiation dosimetric parameters |
| spellingShingle | Yue Teng Dapeng Ma Yan Yan Jianhao Geng Zhiyan Liu Xianggao Zhu Shuai Li Yangzi Zhang Hongzhi Wang Yong Cai Haizhen Yue Yongheng Li Weihu Wang Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer Frontiers in Oncology rectal cancer thrombocytopenia concurrent chemoradiotherapy risk factors clinical predictors radiation dosimetric parameters |
| title | Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer |
| title_full | Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer |
| title_fullStr | Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer |
| title_full_unstemmed | Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer |
| title_short | Retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer |
| title_sort | retrospective cohort study for thrombocytopenia during concurrent chemoradiotherapy for rectal cancer |
| topic | rectal cancer thrombocytopenia concurrent chemoradiotherapy risk factors clinical predictors radiation dosimetric parameters |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1289824/full |
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