Haematological and renal toxicity of radiation therapy in neuroblastoma paediatric patients

• Elías Gomis Sellés ^[1] ; Blas David Delgado León ^[1] ; Patricia Cabrera Roldán ^[1] ; Catalina Márquez Vega ^[2] ; Eleonor Rivin del Campo ^[3] ; José Luis López Guerra ^[1]
  1. [1] Radiation Oncology Department, University Hospital Virgen del Rocío, Biomedical Institute of Seville (IBIS)
  2. [2] Pediatric Oncology Department, University Hospital Virgen del Rocío, Seville
  3. [3] Radiation Oncology Department, Tenon University Hospital, Hôpitaux Universitaires Est Parisien, Sorbonne University Medical Faculty, Paris, France

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 3, 2023, págs. 786-795
• Idioma: inglés
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• Resumen

  • Purpose The objective of this study was to evaluate the renal and hematologic toxicity in paediatric patients with adrenal high-risk neuroblastoma who have received radiation therapy (RT) as part of radical treatment.

    Material and methods Pediatric patients diagnosed with high-risk adrenal neuroblastoma who received RT as part of the definitive treatment between January 2004 and May 2020 in a single institution were selected. Complete blood counts (CBC) and creatinine clearance (CrCl) pre-RT and post-RT were compared through the Wilcoxon signed-rank test and correlated with survival analysis by Cox regression.

    Results Forty-two children with a median age of 3 years at diagnosis and 2.8 years of follow-up were selected. A significant and acute decrease in lymphocytes was found (p = 0.002) 1 month from RT. Patients with a drop higher than 50% of the previous value experimented a significant reduction in overall survival (55 vs 10%; p = 0.031). At the end of the follow-up, a significant increase in all blood counts was observed. With respect to renal function, an acute and significant decrease in CrCl was observed tin patients younger than 4 years who received RT (p = 0.013). However, it was not clinically relevant.

    Conclusion Our data suggest that acute lymphopenia occurs after RT and could be associated with a poorer prognosis. Other blood counts are reduced after RT and all of them are in physiological range at the end of follow-up. Our cohort presented excellent renal outcomes without any case of chronic renal dysfunction.