If blood counts are being checked during concurrent chemoradiation, is there a number at which point you would recommend a radiation treatment break?

I’ll let the platelets go as low as 10K before stopping. I lean heavily on the rate of decline to intervene with a break sooner than the absolute numbers if heading for trouble and later if decline is slow and at reaching the end of treatment.

Usually hold pelvic RT at platelet of < 50K and ANC < 1000 but that being said, if the patient has last few treatments then would complete without holding or switch to a sequential boost plan to help pelvic marrow to recover. Besides if needed, could also consider Neupogen if ANC is the only factor ...

In general, I use these parameters in private practice as "No Treat" thresholds for RT regardless of primary:

• Hgb<=7
• Hct <=21
• Total WBC < 1000
• ANC < 500 to 1000
• Plt < 35

Having said this, most hematological toxicities in our practice come in anal primary, gyn primaries with concurrent chemo and la...