Toxicity Of Hematology And Correlation Analysis In Concurrent Chemoradiotherapy For Squamous Cervical Cancer

Objective:To explore the occurrence and influencing factors of hematological toxicity during treatment of concurrent chemoradiotherapy for locally advanced squamous cervical cancer.Methods:Clinical datas of cases were collected. The patients were locally advanced squamous cervical cancer who treated in Tianjin Medical University General Hospital gynecology in December2004to March2012. And to explore the occurrence and influencing factors of hematological toxicity during treatment of concurrent chemoradiotherapy.Results:The occurrence rate of leucopenia was88.3%(91/103), toxicity of platelets was12.6%(13/103), and toxicity of neutrophils was72.8%(75/103). Leucopenia appearance time was35.63±11.10d after the start of concurrent chemoradiotherapy, and cycles of chemotherapy were5.08±1.696while the toxicity was maximum. Toxicity of platelets appearance time was31.39±12.23d after the start of concurrent chemoradiotherapy, and cycles of chemotherapy were4.44±1.753while the toxicity was maximum. Toxicity of neutrophils appearance time was33.45±12.51d after the start of concurrent chemoradiotherapy, and cycles of chemotherapy were4.78±1.847while the toxicity was maximum. Among the factors, age, the merger of the medical conditions, FIGO stage, clinical type of tumor, cycles of chemotherapy and intra-uterine arterial infusion chemotherapy before concurrent chemoradiotherapy were unconcerned with the level of hematological toxicity (P>0.05). Radiotherapy and chemotherapy programs and duration of concurrent chemoradiotherapy had relationship with the level of hematological toxicity (P<0.05).In these chemotherapy regimens, BLM15mg+DDP30-40mg program with docetaxel40mg+DDP40mg, DDP25mg/m2program, paclitaxel60mg+DDP40mg program, the incidence rate of non-hematologic toxicity, mild hematologic toxicity and severe hematologic toxicity incidence were different (P<0.05);In different radiotherapy schemes, whole pelvic radiotherapy plus four fields irradiation plus brachytherapy program and four fields irradiation plus brachytherapy, the incidence rate of non-hematologic toxicity, mild hematologic toxicity and severe hematologic toxicity were different (P<0.05). Conclusions:Radiotherapy and chemotherapy programs,as well as duration of concurrent chemoradiotherapy are high-risk factors associated with hematological toxicity during treatment of concurrent chemoradiotherapy. It is very important to look for the new radiosensitizer agent, efficiency and low toxicity chemotherapy regimens combined with a suitable radiation therapy,beacause it’s the key to improve survival rate and the quality of life for the advanced squamous cervical cancer patients.