Severe neutropenia caused by palliative radiation therapy in a case of metastatic hormone-sensitive prostate cancer

Q4 Medicine IJU Case Reports Pub Date : 2024-09-25 DOI:10.1002/iju5.12783

Fumisato Maesaka, Atsushi Tomioka, Chie Matsushita, Noriko Horikawa, Kiyohide Fujimoto

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Abstract

Introduction

Radiotherapy for widespread bone metastasis results in severe hematological toxicity.

Case presentation

A 71-year-old male was diagnosed with metastatic hormone-sensitive prostate cancer (cT4N1M1b) and treated with apalutamide and degarelix. Concurrently, palliative radiation therapy was sequentially initiated for the 1st, 5th, and 10th thoracic vertebrae and right femur. On day 35 after treatment, severe neutropenia necessitated treatment interruption and required 23 days for neutrophil recovery with a granulocyte colony-stimulating factor agent.

Conclusion

Owing to the severe hematologic toxicity caused by extensive radiation therapy for multiple bone lesions, treatment prioritization by lesion and avoiding irradiation of the red bone marrow is essential.

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在一例对激素敏感的转移性前列腺癌患者中，姑息放疗导致了严重的中性粒细胞减少症。

导言广泛骨转移放疗会导致严重的血液毒性：一名71岁的男性被诊断为转移性激素敏感性前列腺癌（cT4N1M1b），并接受了阿帕鲁胺和地加瑞克治疗。同时，对第1、5、10胸椎和右股骨依次进行了姑息性放射治疗。治疗后第35天，由于严重的中性粒细胞减少症，治疗不得不中断，并需要23天的时间使用粒细胞集落刺激因子制剂来恢复中性粒细胞：结论：由于对多发性骨病变进行广泛放疗会引起严重的血液学毒性，因此必须根据病变的轻重缓急进行治疗，并避免照射红骨髓。

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