KMID : 0939920220540030907
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´ëÇѾÏÇÐȸÁö 2022 Volume.54 No. 3 p.907 ~ p.916
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Chronological Analysis of Acute Hematological Outcomes after Proton and Photon Beam Craniospinal Irradiation in Pediatric Brain Tumors
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Yoo Gyu-Sang
Yu Jeong-Il Cho Sung-Koo Han Young-Yih Oh Yoon-Jin Lim Do-Hoon Nam Hee-Rim Lee Ji-Won Sung Ki-Woong Shin Hyung-Jin
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Abstract
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Purpose: This study aimed to compare the early hematological dynamics and acute toxicities between proton beam craniospinal irradiation (PrCSI) and photon beam craniospinal irradiation (PhCSI) for pediatric brain tumors.
Materials and Methods: We retrospectively reviewed patients with pediatric brain tumors who received craniospinal irradiation (CSI). The average change in hemoglobin levels (¥ÄHbavg), absolute lymphocyte counts (¥ÄALCavg), and platelet counts (¥ÄPLTavg) from baseline values was evaluated and compared between the PrCSI and PhCSI groups at 1 and 2 weeks after the initiation of CSI, 1 week before and at the end of radiotherapy, and 3?4 weeks after the completion of radiotherapy using t-test and mixed-model analysis.
Results: The PrCSI and PhCSI groups consisted of 36 and 30 patients, respectively. There were no significant differences in ¥ÄHbavg between the two groups at any timepoint. However, ¥ÄALCavg and ¥ÄPLTavg were significantly lower in the PhCSI group than in PrCSI group at every timepoint, demonstrating that PrCSI resulted in a significantly lower rate of decline and better recovery of absolute lymphocyte and platelet counts. The rate of grade 3 acute anemia was significantly lower in the PrCSI group than in in the PhCSI group.
Conclusion: PrCSI showed a lower rate of decline and better recovery of absolute lymphocyte and platelet counts than PhCSI in the CSI for pediatric brain tumors. Grade 3 acute anemia was significantly less frequent in the PrCSI group than in the PhCSI group. Further large-scale studies are warranted to confirm these results.
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KEYWORD
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Proton beam therapy, Photon beam therapy, Craniospinal irradiation, Hematological outcome, Hemoglobin, Lymphocyte, Platelet, Toxicity
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