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

Topics: Radiation Oncology • Gynecologic Cancers • Gastrointestinal Cancers • Medical Oncology • Hematology

For example, concerning throbocytopenia or neutropenia during anal cancer treatment with concurrent mitomycin/5FU, or other pelvic malignancies treated with concurrent CRT.

Answer from: Radiation Oncologist at Academic Institution

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.

Comments

Radiation Oncologist at Mercy Health Physicians Youngstown Specialty Care, LLC
Do the same, except for my cutoff Plt < 20K or ...

Radiation Oncologist at Mon Health
Would a 10 or 20 K treatment threshold put the pat...

Answer from: Radiation Oncologist at Community Practice

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 ...

Answer from: Radiation Oncologist at Community Practice

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 f...

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