ESTRO 2024 - Abstract Book

S4531

Physics - Machine learning models and clinical applications

ESTRO 2024

Bone marrow dose-volume predictors of late lymphopenia after pelvic lymph node irradiation for PCa

Maddalena Pavarini 1 , Lisa Alborghetti 1 , Stefania Aimonetto 2 , Angelo Maggio 3 , Valeria Landoni 4 , Paolo Ferrari 5 , Antonella Bianculli 6 , Edoardo Petrucci 7 , Alessandro Cicchetti 8 , Bruno Farina 9 , Paolo Salmoiraghi 10 , Eugenia Moretti 11 , Elena Cazzulo 12 , Viviana Carillo 13 , Fernando Munoz 14 , Alessandro Magli 15 , Giuseppe Sanguineti 16 , Justyna M Waskiewicz 17 , Luciana Rago 18 , Domenico Cante 19 , Giuseppe Girelli 20 , Tiziana Rancati 8,21 , Nadia G Di Muzio 22,23 , Cesare Cozzarini 22 , Claudio Fiorino 1 1 IRCCS San Raffaele Scientific Institute, Medical Physics, Milano, Italy. 2 Ospedale Regionale Parini-AUSL Valle d’Aosta, Medical Physics, Aosta, Italy. 3 Istituto di Candiolo - Fondazione del Piemonte per l'Oncologia IRCCS, Medical Physics, Candiolo, Italy. 4 IRCCS Istituto Nazionale Tumori Regina Elena, UOSD Laboratorio di Fisica Medica e Sistemi Esperti, Roma, Italy. 5 Comprensorio Sanitario di Bolzano, Medical Physics, Bolzano, Italy. 6 IRCCS Crob, Medical Physics, Rionero in Vulture, Italy. 7 ASL TO4 Ospedale di Ivrea, Medical Physics, Ivrea, Italy. 8 Fondazione IRCCS Istituto Nazionale dei Tumori, Unit of Data Science, Milano, Italy. 9 Ospedale degli Infermi, Medical Physics, Biella, Italy. 10 Cliniche Gavazzeni Humanitas, Medical Physics, Bergamo, Italy. 11 Azienda sanitaria universitaria Friuli Centrale, Medical Physics, Udine, Italy. 12 ASO SS Antonio e Biagio e C. Arrigo, Medical Physics, Alessandria, Italy. 13 Centro AKTIS Diagnostica e Terapia s.p.a., Medical Physics, Napoli, Italy. 14 Ospedale Regionale Parini-AUSL Valle d’Aosta, Department of Radiation Oncology, Aosta, Italy. 15 Azienda Ospedaliero Universitaria S. Maria della Misericordia, Department of Radiotherapy, Udine, Italy. 16 IRCCS Regina Elena National Cancer Institute, Department of Radiation Oncology, Roma, Italy. 17 Comprensorio Sanitario di Bolzano, Radiotherapy, Bolzano, Italy. 18 IRCCS Crob, Radiotherapy, Rionero in Vulture, Italy. 19 ASL TO4 Ospedale di Ivrea, Radiotherapy, Ivrea, Italy. 20 Ospedale degli Infermi, Department of Radiotherapy, Biella, Italy. 21 Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Epidemiology and Data Science, Milano, Italy. 22 IRCCS San Raffaele Scientific Institute, Department of Radiation Oncology, Milano, Italy. 23 Vita-Salute San Raffaele University, Medicine and Surgery, Milano, Italy

Purpose/Objective:

To detect clinical/dosimetric predictors of late hematological toxicity (HT) in a prospective multi-institute cohort study on prostate cancer (PCa) patients undergoing whole-pelvis radiotherapy (WPRT).

Material/Methods:

In September 2012 a multi-centric institutional review board-approved study was activated at San Raffaele Scientific Institute, Milan, to evaluate clinical/dosimetric predictors of toxicity (including HT) in WPRT. Enrolled PCa patients were irradiated (with radical intent or post-surgery) and followed for 5-years. Preliminary results concerning DVH predictors of HT were previously reported [1]. Four pelvic bones volumes were contoured: ilium (BMILEO), from iliac crests top to the superior border of the femoral heads; lumbosacral spine (BMLS), from the most superior vertebral body where the lymph-node planning treatment volume (PTVLN) contours begin to the sacrum, included; lower pelvis (BMPELVIS), with pubes, ischia, acetabula, and proximal femora; and whole pelvis (BMTOT), the union of the three subvolumes [2]. Their dose-volume histograms (DVHs) were extracted in absolute values (cc) and volumes receiving a dose ≥0Gy up to 70Gy with a 1Gy pitch were calculated. Integral doses (IDs) were computed as the product of the mean dose to the structure and its volume. The PTVLN volume (cc) and the craniocaudal extent (mm) from the L5 vertebrae lower edge to the PTVLN upper extremity were computed.