Incidence of Hematological Toxicity in Pelvic Irradiation

Abstract

Background: Radiotherapy (RT) is one of the effective therapeutic procedures in treatment of malignancies. It utilizes either electromagnetic radiations or particulate radiations, which cause damage to cancerous cells but may also affect normal cells. Pelvis is one of the most commonly involved sites in malignancies. RT to the pelvis can lead to pelvic radiation disease (PRD), as well as hematological toxicity which is an important complication that may affect the treatment plan and includes anemia, leukopenia, and thrombocytopenia.

Aim of the Study: To determine the effect of pelvic irradiation on hematological panels: (white blood cell count, hemoglobin, and platelet count) in patients requiring RT for the pelvis.

Methodology: The study is a prospective comparative study conducted on 67 patients undergoing RT to the pelvis in Baghdad RT and Nuclear Medicine Center in Medical City of Baghdad from October 2018 through February 2019. Hematological measurements were collected from the patients in three stages: first fraction, during RT, and after the last fraction.

Results: There was a significant reduction of 2.25 g/dL in hemoglobin level between first and third measurement (p < 0.001). There was a significant reduction of 2’730 cells/μL in white blood cells count between first and third measurement (p < 0.001). Similarly, there was a significant reduction of 92’310 cells/μL in platelet count between first and third measurement (p < 0.001). Concurrent therapy was significantly related to reduction in all the three hematological parameters.

Conclusions: Exposure of the pelvis to RT significantly reduces the hematological parameters of the patients, namely hemoglobin level, white blood cells count, and platelets count