Abstract | AIMS AND BACKGROUND: Symptomatic, massive splenomegaly is a debilitating complication of myeloproliferative disorders. In the study, we evaluated the use of a contemporary, individualized radiotherapeutic approach for splenic irradiation, including 3-dimensional computed tomography-based treatment planning, individualized treatment margins based on splenic motion assessment, online setup verification with volumetric image guidance at each fraction, and adaptive radiation treatment planning to account for changes in splenic size during the fractionated radiotherapy course. METHODS AND STUDY DESIGN: Between December 2008 and January 2014, 18 patients (13 males, 5 females) with myeloproliferative disorders referred to Gulhane Military Medical Academy Radiation Oncology Department underwent 22 courses of splenic irradiation using 3-dimensional computed tomography-based treatment planning and volumetric image guidance for palliation of symptomatic splenomegaly. RESULTS: Median age was 64 years (range 28-79). Significant pain relief was achieved in 20 of the 22 splenic irradiation courses (90.9%). Improvement in hematological parameters was achieved in 8 of the 11 splenic irradiation courses applied for cytopenia (72.7%). At least a 50% reduction in splenic size was achieved in 18 of the 22 splenic irradiation courses (81.8%). Toxicity was manageable with supportive treatment including antiemetics and platelet or red blood cell transfusions. CONCLUSIONS:
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Authors | Omer Sager, Murat Beyzadeoglu, Ferrat Dincoglan, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Mustafa Akin, Esin Gundem, Bahar Dirican |
Journal | Tumori
(Tumori)
2015 Jan-Feb
Vol. 101
Issue 1
Pg. 84-90
ISSN: 2038-2529 [Electronic] United States |
PMID | 25702680
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Dose Fractionation, Radiation
- Female
- Humans
- Imaging, Three-Dimensional
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
(complications)
- Male
- Middle Aged
- Myeloproliferative Disorders
(complications)
- Palliative Care
(methods)
- Precision Medicine
- Primary Myelofibrosis
(complications)
- Radiotherapy Planning, Computer-Assisted
- Retrospective Studies
- Splenomegaly
(etiology, radiotherapy)
- Tomography, X-Ray Computed
- Treatment Outcome
- Turkey
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