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Α Β Γ Δ Ε Ζ Η Θ Ι Κ Λ Μ Ν Ξ Ο Π Ρ Σ Τ Υ Φ Χ Ψ Ω α β γ δ ε ζ η θ ι κ λ μ ν ξ ο π ρ σ τ υ φ χ ψ ω
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        Impact of hematologic toxicities during concurrent chemoradiation for cervical cancer

        Feiya Shi,Alison K. Yoder,Claire Mach,Shraddha Dalwadi,Matthew L Anderson,Tracilyn R Hall,Michelle S Ludwig 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.2

        ObjectiveTo evaluate the prognostic significance of hematological toxicities during cervical cancer treatment. MethodsPatients treated for cervical carcinoma with definitive chemoradiation were identified. Toxicities were assessed duringweeks 1 to 6 of concurrent external beam radiation and chemotherapy. Outcomes were analyzed using Cox regressionanalysis. ResultsOne hundred twenty-one patients with Federation of Gynecology and Obstetrics stage I-III disease were eligible foranalysis. 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 commongrade 3+ toxicities were low absolute lymphocyte count (n=115, 95%), low white blood cell count (n=21, 17%), andanemia (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), progressionfreesurvival (HR, 3.4; P=0.001), and local control (HR, 4.1; P=0.047). Anemia grade 3, 4 was also associated withreduced overall survival (HR, 4.1; P=0.014). After controlling for disease and treatment variables, grade 4 lymphopeniaremained significantly associated with reduced overall survival (HR, 9.85; P=0.007). The association with grade 4lymphopenia only remained significant in women of Hispanic ethnicity. ConclusionSevere lymphopenia was associated with reduced overall survival and progression-free survival in Hispanic womenundergoing definitive chemoradiation for cervical cancer, but not associated with outcomes in non-Hispanic women.

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