A Prospective and Observational Study to Assess the Hematological Toxicities of Concurrent Chemoradiation Therapy Inpatients with Locally Advanced Cancersin a Tertiary Care Teaching Hospital

Abstract

Aim: Cancer ranks as the second most prevalent non-communicable disease worldwide, urging exploration into
acute and late chemoradiation-induced hematological toxicities in patients with head-and-neck cancer (HNC) and
uterine cervix cancer (UCC). Material and Methods: Our prospective observational study, conducted in a tertiary
care teaching hospital, enrolled 60 cancer patients aged over 18 years. Utilizing the National Cancer Institute
Common Terminology Criteria for Adverse Events, we assessed toxicity levels. Results and Discussion: Results
revealed a gender disparity, with females exhibiting higher frequency (73.3%), and the highest frequency occurring
among individuals aged 41–50 years (36.7%). Comparing tumor types, HNC exhibited lower carcinoma incidence
than UCC (68.3%). Hematological profiles during chemoradiation therapy revealed Grade 1 anemia (24%) in the
1st week and Grade 3 toxicities in subsequent weeks. Notably, Grade 5 toxicity and Grade 1 thrombocytopenia
(23%) were observed. Grade 1 neutropenia was predominant in the 2nd–4th weeks (21%), while additional cases
of Grade 1 lymphocytopenia surfaced in the 2nd week. Grade 4 toxicities peaked in the 1st and 3rd weeks (29%),
with leucopenia prevalent in the 3rd week (13.3%). Conclusion: While these toxicities are generally manageable
and self-limiting, vigilance is warranted to avert severe complications like febrile neutropenia and anemia,
emphasizing the need for prompt intervention to prevent life-threatening outcomes.