Effect of prophylactic granulocyte-colony stimulating factor (G-CSF) on acute hematological toxicity in medulloblastoma patients during craniospinal irradiation (CSI).

R Madan, N Kumar, A Gupta, K Gupta, P Salunke, D Khosla, B S Yadav, R Kapoor

Journal: Clinical neurology and neurosurgery 2021;196():105975

PMID: 32505868

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

Haematological toxicity and treatment breaks are common during cranio-spinal irradiation (CSI) due to irradiation of large volume of bone marrow. We conducted this study to see the effect of prophylactic granulocyte colony stimulating factor (GCSF) in reducing treatment breaks.

PATIENTS AND METHODS

The study was conducted over a period of 15 months from August 2017 to November 2018. Histopathologically proven Medulloblastoma patients received prophylactic GCSF during CSI. Acute hematological toxicities and treatment breaks were noted and effect of age and pretreatment blood counts were analyzed by SPSS (Statistical Package for Social Sciences) version 23.

RESULTS

A total of 28 patients were included in the study. During CSI, hematological toxicity leading to treatment breaks was observed in 11 (39.3 %) patients, of which grade 3 and 2 toxicities were seen in ten and one patients respectively. Younger age (<10 years) at diagnosis was significantly associated with the development of hematological toxicity (p = 0.028, Chi-Square). No correlation was found with pre-treatment blood counts.

CONCLUSION

Prophylactic use of GCSF may be effective in preventing radiation induced hematological toxicity and treatment breaks.

Address: Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India.; Department of Radiotherapy and Oncology, PGIMER, Chandigarh, India. Electronic address: [email protected].; Department of Pathology, PGIMER, Chandigarh, India.; Department of Neurosurgery, PGIMER, Chandigarh, India.

DOI: 10.1016/j.clineuro.2020.105975

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MeSH Terms: Acute Disease, Adolescent, Adult, Antineoplastic Agents, Phytogenic, Bone Marrow Diseases, Cerebellar Neoplasms, Child, Child, Preschool, Combined Modality Therapy, Craniospinal Irradiation, Drug Administration Schedule, Female, Granulocyte Colony-Stimulating Factor, Hematologic Diseases, Humans, Male, Medulloblastoma, Prospective Studies, Radiotherapy Dosage, Radiotherapy, Conformal, Spinal Cord Neoplasms, Vincristine, Young Adult