Page 9 - ARNM-2-1

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
Comprehensive analysis of myelosuppression of

pediatric patients receiving radiotherapy

2
1
Yijie Sun , Hongjia Liu , Chenguang Li , Yubin Li , Huamu Xie , and
3
4
2
Yibao Zhang *
2
1 Department of Education, Peking University People’s Hospital, Beijing, China
2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing),
Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University
Health Science Center Institute of Medical Technology, Beijing, China
3 Department of Education, Peking University Health Science Centre, Beijing, China
4 State Key Laboratory of Nuclear Physics and Technology, School of Physics, Institute of Heavy Ion
Physics, Peking University, Beijing, China

Abstract
Pediatric oncology management necessitates distinct strategies for radiotherapy
due to the heightened sensitivity of pediatric bone marrow to radiation
exposure compared to adults. Therefore, this study aimed to compare the risk of
radiation-induced myelosuppression between pediatric and adult patients by
analyzing the correlations between gender, age, active marrow distribution, and
radiation-induced myelosuppression. The medical records of 49 pediatric patients
aged <15 years were retrospectively analyzed. Subgroup analyses based on sex
and age were conducted to compare this pediatric patient data with data from
*Corresponding author:
Yibao Zhang adult patients reported in the literature. The observed rate of radiation-induced
(zhangyibao@pku.edu.cn) myelosuppression in the pediatric group was 59.18%, which was approximately
twice the rate for the adult group (34%) reported in literature. Notably, the rates
Citation: Sun Y, Liu H, Li C, Li Y,
Xie H, Zhang Y. Comprehensive of leukopenia and granulocytopenia were observed in 53% and 45% of patients
analysis of myelosuppression suffering from radiation-induced myelosuppression, respectively, compared to rates
of pediatric patients receiving of thrombocytopenia and hemoglobinopenia observed in only 10% of patients,
radiotherapy. Adv Radiother Nucl
Med. 2024;2(1):2519. indicating that white blood cells and granulocytes are more sensitive indicators
https://doi.org/10.36922/arnm.2519 of radiation-induced myelosuppression. Our findings revealed that pediatric
Received: December 23, 2023 patients receiving radiotherapy in the head-and-neck regions face a higher risk
of radiation-induced myelosuppression than adult patients due to the changes in
Accepted: February 26, 2024
active bone marrow during childhood development. Therefore, careful consideration
Published Online: March 26, 2024 of radiation-induced myelosuppression is essential during protocol optimization for
Copyright: © 2024 Author(s). pediatric patients receiving radiotherapy outside the pelvic region.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: Target delineation; Pediatric oncology patients; Myelosuppression; Radiation-
License, permitting distribution, induced injury; Radiotherapy
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in 1
published maps and institutional Pediatric tumors are the sixth-largest contributor to the global tumor burden. Despite
affiliations. their substantial impact, there exists a significant scarcity of data on the management

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