In:
BioMed Research International, Hindawi Limited, Vol. 2017 ( 2017), p. 1-10
Abstract:
Rationale . Radium-223-Dichloride (Ra-223) is an alpha-emitter, used to treat bone metastases. Patients with high metastatic burden and/or with increased trabecular bone uptake could present a higher incidence of hematologic toxicity. We hypothesized that these two factors are predictors of bone marrow failure. Material and Methods . A computer algorithm discriminated between trabecular bone ( B V o l ) and tumor metastases ( M V o l ) within pretherapeutic whole-body skeletal SPECT/CT ( N = 47 ). The program calculated the metastatic invasion percent (INV%) as the M V o l / ( M V o l + B V o l ) ratio and extracted the B V o l mean counts. B V o l counts were correlated to % drop of hemoglobin (Hb), leukocytes (WBC), and platelets (PLT) after 3/6 Ra-223 cycles. Patient-specific and computational-derived parameters were tested as predictors of hematologic toxicity with MANOVA. Results . B V o l counts correlated with drop of Hb ( R = 0,65, p 〈 0.01 ) and PLT ( R = 0,45, p 〈 0.01 ). Appendicular B V o l counts showed a better correlation ( p 〈 0.05 , p 〈 0.01 , and p 〈 0.001 for Hb, WBC, and PLT, resp.). INV% directly correlated with B V o l counts ( R = 0.68, p 〈 0.001 ). At MANOVA, grade III/IV toxicity was predicted by INV% ( p 〈 0.01 ), by long-bone invasion ( p 〈 0.005 ), and by B V o l counts ( p 〈 0.05 ). Conclusions . In patients with significant bone tumor burden, degree of bone invasion and trabecular bone uptake are predictors of subsequent bone marrow failure.
Type of Medium:
Online Resource
ISSN:
2314-6133
,
2314-6141
DOI:
10.1155/2017/3905216
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2017
detail.hit.zdb_id:
2698540-8
Permalink