Predictors of Clinical Hematological Toxicities under Radiotherapy in Patients with Cervical Cancer-A Risk Analysis

Area of Science:

• Oncology
• Radiation Oncology
• Hematology

Background:

• Cervical cancer is a leading global female cancer with high mortality.
• Concurrent chemoradiotherapy improves survival but causes toxicities.
• Whole pelvis radiotherapy can lead to myelosuppression and hematological issues due to bone marrow content.

Purpose of the Study:

• To identify clinical and hematological predictors of adverse reactions in cervical cancer patients undergoing radiotherapy.
• To analyze the relationship between treatment parameters and hematological toxicity.

Main Methods:

• Retrospective cohort study of 69 patients with IB-IVB cervical cancer.
• Analysis of clinical adverse events and blood cell counts (hemoglobin, neutrophils, leukocytes, platelets).
• Data collected from 2018-2021 at the Oncological Institute of Bucharest.

Main Results:

• Hemoglobin decrease associated with BMI > 23.2 kg/m², age > 53 years, 3D conformal radiotherapy, and EQD2 > 66.1 Gy.
• Neutropenia linked to gastrointestinal side effects and bowel/rectal V45 isodoses.
• Leukocyte nadir observed before day 35 with 3D conformal radiotherapy; low neutrophil and platelet counts associated with 54 Gy pelvic dose.

Conclusions:

• Clinical and blood parameters predict hematological adverse reactions in cervical cancer patients.
• Patients with risk factors (obesity, age > 53) and borderline low blood counts require close monitoring (days 29-35 post-RT).
• Early identification of at-risk patients can guide management and mitigate toxicity.