AccScience Publishing / ARNM / Volume 2 / Issue 1 / DOI: 10.36922/arnm.2519
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ORIGINAL RESEARCH ARTICLE

Comprehensive analysis of myelosuppression of pediatric patients receiving radiotherapy

Yijie Sun1 Hongjia Liu2 Chenguang Li2 Yubin Li3 Huamu Xie4 Yibao Zhang2*
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1 Department of Education, Peking University People’s Hospital, Beijing, China
2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University Health Science Center Institute of Medical Technology, Beijing, China
3 Department of Education, Peking University Health Science Centre, Beijing, China
4 State Key Laboratory of Nuclear Physics and Technology, School of Physics, Institute of Heavy Ion Physics, Peking University, Beijing, China
Submitted: 23 December 2023 | Accepted: 26 February 2024 | Published: 26 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Pediatric oncology management necessitates distinct strategies for radiotherapy due to the heightened sensitivity of pediatric bone marrow to radiation exposure compared to adults. Therefore, this study aimed to compare the risk of radiation-induced myelosuppression between pediatric and adult patients by analyzing the correlations between gender, age, active marrow distribution, and radiation-induced myelosuppression. The medical records of 49 pediatric patients aged <15 years were retrospectively analyzed. Subgroup analyses based on sex and age were conducted to compare this pediatric patient data with data from adult patients reported in the literature. The observed rate of radiation-induced myelosuppression in the pediatric group was 59.18%, which was approximately twice the rate for the adult group (34%) reported in literature. Notably, the rates of leukopenia and granulocytopenia were observed in 53% and 45% of patients suffering from radiation-induced myelosuppression, respectively, compared to rates of thrombocytopenia and hemoglobinopenia observed in only 10% of patients, indicating that white blood cells and granulocytes are more sensitive indicators of radiation-induced myelosuppression. Our findings revealed that pediatric patients receiving radiotherapy in the head-and-neck regions face a higher risk of radiation-induced myelosuppression than adult patients due to the changes in active bone marrow during childhood development. Therefore, careful consideration of radiation-induced myelosuppression is essential during protocol optimization for pediatric patients receiving radiotherapy outside the pelvic region.

Keywords
Target delineation
Pediatric oncology patients
Myelosuppression
Radiation-induced injury
Radiotherapy
Funding
This study was supported by the National Nature Science Foundation of China (award number: 12275012) and the Natural Science Foundation of Beijing Municipality (award number: Z210008).
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Conflict of interest
The authors declare that they have no competing interests.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing