Hematologic Toxicity of Conformal Radiotherapy and Intensity Modulated Radiotherapy in Prostate and Bladder Cancer Patients

Abstract

Background: The purpose of this study was to compare hematologic adverse effects and hematologic toxicity<br />(HT) of pelvic irradiation in patients treated with conformal radiotherapy (CRT) and intensity modulated radiotherapy<br />(IMRT) for radical treatment of prostate and bladder cancer. Methods: A group of 115 patients with prostate or bladder<br />cancer treated with definitive radical radiotherapy was evaluated retrospectively. Blood test were taken before and<br />after treatment comprising of following indices: white blood cells (WBC) hemoglobin (HGB), red blood cell (RBC),<br />lymphocyte (LC), neutrophil (NC) and platelet (PLT) count. Patients were divided into several subgroups and the data<br />was evaluated statistically using absolute and relative values. Results: There was a statistically significant difference<br />in WBC (p=0.007), NC (p=0.031) and PLT (p=0.026) count decrease (absolute values) after treatment, between two<br />treatment methods (CRT and IMRT), all in favor of IMRT. The relationship still proves to be significant regarding<br />WBC (p=0,02) and (NC) (p=0,049) after presenting the data as relative percentage loss of starting value. However<br />using Common Terminology Criteria for Adverse Effects (CTCAE), PLT count toxicity was more common in IMRT<br />group (p=0.045). Conclusion: IMRT in comparison to CRT in bladder and prostate cancer patients is associated with a<br />lesser absolute and relative decrease of hematologic indices. The hematologic effect of radiation was observed mainly<br />regarding LC. Patients treated with IMRT suffered from significantly lesser decrease in relative and absolute values<br />of WBC and NC. The mean of absolute PLT decrease count was lower in IMRT group; however, toxicity according to<br />CTCAE was slightly more prevalent in IMRT group.