title: Hematologic changes during prostate cancer radiation therapy are dependent on the treatment volume.
abstract: OBJECTIVE
  To assess hematologic changes of modern prostate radiation therapy (RT) comparing different target volumes.
  
  
  METHODS
  Blood samples were evaluated before (T1), during (T2-T4) and 6-8 weeks after (T5) RT in a group of 113 patients. Whole-pelvic RT up to 46 Gy was applied in 27 cases. The total dose to the prostatic fossa (n = 46)/prostate (n = 67) was 66/76 Gy.
  
  
  RESULTS
  Erythrocyte, leukocyte and platelet levels decreased significantly relative to baseline levels at T2-T5. Neoadjuvant hormonal therapy had an impact on hemoglobin levels before and during RT. The cumulative incidence of grade 2 leukopenia was 15 versus 2% (p = 0.02) and grade 2 anemia 8 versus 0% (p = 0.03) with versus without whole-pelvic RT, respectively. Lymphocyte decrease was larger at times T2-T5 (36 vs 3% grade 3 toxicity; p < 0.01).
  
  
  CONCLUSIONS
  Prostate RT has a small but significant and longer effect on the blood count. Lower lymphocyte levels need to be considered when larger volumes are treated.
authors.affiliation: Department of Radiation Oncology, Rheinisch-Westfaelische Technische Hochschule Aachen University, Pauwelsstrasse 30, 52057 Aachen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Pinkawa
authors.forename: Victoria
authors.initials: V
authors.lastname: Djukic
authors.forename: Jens
authors.initials: J
authors.lastname: Klotz
authors.forename: Dalma
authors.initials: D
authors.lastname: Petz
authors.forename: Marc D
authors.initials: MD
authors.lastname: Piroth
authors.forename: Richard
authors.initials: R
authors.lastname: Holy
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Eble
mesh_terms: D001772:Blood Cell Count; D001792:Blood Platelets / Q000528:radiation effects; D003131:Combined Modality Therapy; D004912:Erythrocytes / Q000528:radiation effects; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008214:Lymphocytes / Q000528:radiation effects; D008297:Male; D020360:Neoadjuvant Therapy / Q000009:adverse effects* / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D006454:Hemoglobins; D017430:Prostate-Specific Antigen