ABSTRACT
Objective:To investigate the association between pelvic bone dose-volume parameters and acute bone marrow suppression in cervical cancer treated with concurrent cisplatin and intensity-modulated radiation therapy, in order to provide the limited prescription for making radiotherapeutic plan.Methods:The clinical data of 40 cervical cancer patients receiving cisplatin with concurrent intensity-modulated radiation therapy in the Affiliated Hospital of Ningde Normal College from November 2017 to January 2020 were analyzed. The correlations of the irradiated volume of pelvic bone receiving doses of 5, 10, 15, 20, 25, 30, 35, 40, 45, 50 Gy as a percentage of the total volume of pelvic bone (V 5 Gy,V 10 Gy, V 15 Gy,V 20 Gy,V 25 Gy, V 30 Gy, V 35 Gy, V 40 Gy, V 45 Gy, V 50 Gy), the maximum dose (D max), the minimum dose (D min), and the mean dose (D mean) with the occurrence of ≥grade 3 acute bone marrow suppression were analyzed. The logistic multiple regression analysis was used to study the influencing factors of ≥grade 3 acute bone marrow suppression, and the receiver operating characteristic (ROC) curve was used to determine the diagnostic efficacy of influencing factors for ≥grade 3 acute bone marrow suppression. Results:The incidence rate of ≥grade 3 acute bone marrow suppression was 47.5% (19/40). Between patients with ≥grade 3 and <grade 3 acute bone marrow suppression, the differences in pelvic bone V 5 Gy [(96.0±2.9)% vs. (93.4±3.5)%], V 10 Gy [(90.6±5.0)% vs. (87.5±4.0)%], V 15 Gy [(86.2±5.8)% vs. (83.0±4.2)%], V 20 Gy [(78.8±6.1)% vs. (74.6±4.5)%], V 50 Gy [(15.8±7.1)% vs. (10.2±7.1)%], D max [(6 376±524) cGy vs. (5 813±668) cGy] and D mean [(3 441±255) cGy vs. (3 239±240) cGy] were statistically significant (all P < 0.05). The logistic multiple regression analysis showed that pelvic bone V 5 Gy was an risk factor for the occurrence of ≥ grade 3 acute bone marrow suppression [ OR = 3.108, 95% CI 1.101-8.768, P = 0.032], and the ROC curve showed that the optimal critical value of pelvic bone V 5 Gy was 96.9%, and the area under the curve was 0.709. Conclusions:During cisplatin with concurrent intensity-modulated radiation therapy for cervical cancer, pelvic bone V 5 Gy is a risk factor for the occurrence of ≥ grade 3 acute bone marrow suppression. Setting pelvic bone V 5 Gy below 96.9% when making the radiotherapy plan can effectively reduce the occurrence of ≥ grade 3 acute bone marrow suppression.
ABSTRACT
Objective To investigate the level of platelet parameter of uterine cervical cancer patients and its clinical significance. Methods Seventy-four cases with cervical cancer (the observation group) from Ningde Municipal Hospital, the Affiliated Hospital of Fujian Medical University from May 2014 to May 2016 were chosen as the research subjects. Seventy-four cases of healthy people were treated as the control group. According to the International Federation of Gynecology and Obstetrics (FIGO), the observation group was divided into 15 cases under stage ⅡB(the early stage group), 59 cases of ⅡBstage and above (the middle and advanced stage group). Platelet count (Plt) and mean volume of platelet were monitored and compared by using Japan automatic blood cell analyzer. Results Plt in the observation group was higher than that in the control group [(266 ±71) × 109/L vs. (215 ±42) × 109/L, respectively], and the difference was statistically significant (t = 5.322, P＜ 0.05). The average volume of platelet in the observation group was lower than that in the control group [(9.2±1.2) fl vs. (9.9±1.3) fl, respectively], and the difference was statistically significant (t =-3.931, P ＜ 0.05); There was no statistical difference in the Plt and mean volume of platelet between the early stage group and the middle and advanced stage group (both P＞0.05). Conclusions The determination of platelet parameter has a certain clinical significance for screening and early detection of uterine cervical cancer.