Routine blood monitoring during adjuvant radiotherapy for breast cancer patients

Abstract

Routine blood monitoring during adjuvant radiotherapy (RT) are commonly used to monitor for bone marrow suppression from radiation. Researches in the past showed the importance of blood monitoring, but no definite consensus or guidelines about frequency and appropriate times for blood tests. This research retrospectively reviewed charts of breast cancer patients who received radiation after surgery and chemotherapy since 2005 to 2014. The aims of research are to study characters of complete blood counts (CBCs) before and during radiotherapy together with the necessity of weekly CBCs monitoring. Severity of mean blood cells changes are defined by Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. The charts of 222 female breast cancer patients were reviewed. The average age was 51 ± 9.64 years. Majority of patients was stage IIIA (35.14 %). Before radiation, mean counts of all blood cell types ranged between normal and grade 1 adverse event (AE). Between radiotherapy, most of blood cells declined continuously to the lowest levels (nadir phase) in the last week of treatment. Mean counts of all blood cell types in nadir phase ranged between normal and grade 2 AE. All those counts were above critical levels. No patients experienced severe complications or treatment break. In conclusion, even though adjuvant radiotherapy for breast cancer patients after mastectomy and chemotherapy causes bone marrow suppression, mean values of all blood cell types were above critical level and showed no clinical significance. This study revealed that routine weekly CBCs might not be necessary for breast cancer patients who received adjuvant radiation after surgery and chemotherapy completion. CBCs before RT, during 1st and 3rd weeks of RT give adequate information to radiotherapist for awareness of bone marrow suppression and patient care during radiotherapy.