Page 11 - ARNM-2-1

Advances in Radiotherapy
& Nuclear Medicine Pediatric myelosuppression in radiotherapy

between gender- and radiation-induced myelosuppression after propensity score matching is presented in Table 6.
(odds ratio [OR] = 1.75; 95% confidence interval The results revealed that gender was not associated with
[CI]: 0.52 – 5.87; P > 0.05). post-radiotherapy myelosuppression (OR = 1.47, 95%
CI: 0.19 – 12.40, P > 0.05).
3.2.2. Subgrouping according to age
Next, patients were stratified based on an age cutoff of
The patients were divided according to age, using a cutoff 10 years, and the differences in gender, prescribed dose,
of 10. No differences were observed between the two age treatment fraction, and treatment duration between the
subgroups in terms of the location of radiotherapy in two groups were depicted using median and quartile ranges
the study, as depicted in Table 3. As shown in Table 4, no due to the different sample sizes. After propensity score
significant association was observed between age- and matching, 14 patients aged ≤10 years and 14 patients aged
radiation-induced myelosuppression (OR = 1.40, 95% >10 years were included in the study. The differences in
CI: 0.42 – 4.26, P > 0.05). gender, prescribed dose, treatment fraction, and treatment

3.2.3. Subgrouping analysis duration between the two groups were not statistically
significant (P > 0.05). Detailed information is provided in
To determine the radiation dose, the patients were divided Table 7. A case–control study of the relationship between
into two groups using propensity score matching. age and myelosuppression after radiotherapy is presented
First, the two groups were divided according to their in Table 8, revealing no association between age and
gender. After propensity score matching, ten male and ten post-radiotherapy myelosuppression after grouping by age
female patients were included, and the differences in age, (OR = 0.76, 95% CI: 0.13 – 4.20, P > 0.05).
prescribed dose, treatment fraction, and treatment duration
between the two groups were not statistically significant 4. Discussion
(P > 0.05). Detailed information is presented in Table 5. Radiation-induced injury to normal tissues and organs
The relationship between gender and myelosuppression is a key challenge in radiotherapy. Due to growth and
development, the consequences and long-term risks of
Table 2. Relationship between sex and bone marrow radiological injury are more severe in children than in
13
suppression after radiotherapy adults. As a result, there is a consensus among scholars to
make special considerations for pediatric patients during
Myelosuppression after radiotherapy treatment plan optimization that is different from those for
Yes No adults. However, the specific implementation strategies for
Male 21 12 different organs require further study.
Female 8 8
The work by Pearce et al. demonstrated that exposure
14
to ionizing agents during computed tomography (CT)
Table 3. Location of radiotherapy in two age subgroups scanning significantly increased the risk of leukemia in
pediatric patients by affecting the red bone marrow. As
Radiotherapy regions Age≤10 Age>10 the radiotherapy dose is much higher than the imaging
Head and neck 18 21 dose, exposure to radiotherapy in the red bone marrow
Chest and abdomen 1 5 of pediatric patients increases the risk of uncertain
Foot 0 1 effects, such as secondary carcinogenicity. Radiotherapy
Femur 0 1 also directly increases the risk of side effects such as
Tibia 0 1 myelosuppression, which is clinically manifested by
Fibula 0 1 significant changes in routine blood parameters and is one
Upper limbs 0 1 of the major risks during radiotherapy in pediatric patients.
The present study revealed that, compared to the reported
incidence of radiation-induced myelosuppression of more
Table 4. Relationship between age and bone marrow than grade II in approximately 32% of adult patients in the
suppression after radiotherapy head and neck regions, the incidence in pediatric patients

Age Myelosuppression after radiotherapy was 59.18%, approximately double that of adults. Another
Yes No study on radiation-induced myelosuppression of more
than grade III in adults and children observed a similar
≤10 years 11 9 phenomenon: the percentage of leukopenia of more than
>10 years 18 11 grade III was 32%, which was higher than that of 3% in the

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/arnm.2519