Acute adverse reactions observation of craniospinal irradiation with helical tomotherapy in patients with medulloblastoma

Abstract

Objective \nTo investigate the acute adverse reactions of craniospinal irradiation with helical tomotherapy in medulloblastoma patients and its risk factors. \n \n \nMethods \nA total of 20 patients with medulloblastoma who received craniospinal irradiation with helical tomotherapy between October 2012 and September 2016 in Air Force General Hospital were selected. The acute adverse events of 20 patients during the treatment were record. According to National Cancer Institute Common Terminology Criteria Adverse Events (NCI-CTCAE) version 4.0, the adverse reactions were divided into the mild group (grade 0-Ⅱ) and severe group (grade Ⅲ-Ⅳ) adverse reactions. And the risk factors were also analyzed. \n \n \nResults \nThe non-hematological adverse reactions included fatigue (55%), vomiting (45%) and headache (25%). The hematological adverse reactions included leukopenia (95%), thrombocytopenia (55%) and lower hemoglobin (45%), and the incidence of severe adverse reactions was 35% (7/20), 20% (4/20) and 0 (0/20), respectively. Leukopenia occurred in 18 patients (90%) at the beginning of radiotherapy within 2 weeks, and thrombocytopenia occurred in 8 patients (40%) at the beginning of radiotherapy after 2 weeks. Single factor analysis showed that there were no statistical differences in hematological adverse events of gender, age and radiation dose of spinal cord (all P > 0.05). The incidence of leukopenia for the patients who received the chemotherapy before the radiotherapy was higher than that for the patients without the chemotherapy before the radiotherapy (P < 0.05). \n \n \nConclusions \nThe hematological adverse reactions were the major acute adverse events during the craniospinal irradiation with helical tomotherapy in patients with medulloblastoma. The incidence of leukopenia and thrombocytopenia is common, and the incidence of hematological adverse reactions is higher after the chemotherapy. Thus, the close monitoring of hemogram change and treatment of hematological adverse reactions in time during the radiotherapy should be taken into the consideration. \n \n \nKey words: \nMedulloblastoma;\xa0Tomography, spiral computed;\xa0Adverse reactions