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.
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.
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.
Splenic irradiation with a contemporary radiotherapeutic approach offers safe and effective palliation of symptomatic splenomegaly in myeloproliferative disorders.
Tumori 2015; 101(1): 84 - 90
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsOmer Sager, Murat Beyzadeoglu, Ferrat Dincoglan, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Mustafa Akin, Esin Gundem, Bahar Dirican
- • Accepted on 23/06/2014
- • Available online on 03/02/2015
- • Published in print on 20/03/2015
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- Sager, Omer [PubMed] [Google Scholar] , * Corresponding Author (firstname.lastname@example.org)
- Beyzadeoglu, Murat [PubMed] [Google Scholar]
- Dincoglan, Ferrat [PubMed] [Google Scholar]
- Demiral, Selcuk [PubMed] [Google Scholar]
- Uysal, Bora [PubMed] [Google Scholar]
- Gamsiz, Hakan [PubMed] [Google Scholar]
- Akin, Mustafa [PubMed] [Google Scholar]
- Gundem, Esin [PubMed] [Google Scholar]
- Dirican, Bahar [PubMed] [Google Scholar]
Department of Radiation Oncology, Gulhane Military Medical Academy, Ankara - Turkey