Impact of Radiotherapy on Electrolyte and Hematological Parameters in Prostate Cancer: Curative vs. Palliative Groups
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Abstract
Background: Prostate cancer is one of the most common cancers in men, with radiotherapy being a key treatment modality. However, radiotherapy often leads to hematological and electrolyte imbalances, adversely impacting patient outcomes. This study aims to assess the impact of radiotherapy on electrolyte levels (sodium, potassium, calcium, magnesium, phosphate, and chloride) and hematological parameters (leukocyte, erythrocyte, hemoglobin, hematocrit, and platelets) in prostate cancer patients. The study also compares these effects between curative and palliative treatment groups.Methods: Twenty prostate cancer patients were included in the study, divided into curative (n=10) and palliative (n=10) groups. Blood samples were collected before and after radiotherapy, they were analyzed using the Swelab Alpha analyzer, while electrolyte levels were measured with Jokoh Ex-DS and Roche Integra 400 Plus analyzers. Patients received 3DCRT and VMAT. Results: Significant differences were observed in calcium (p = 0.018) and phosphate (p = 0.005) levels, with higher values in the curative group. Other electrolytes (magnesium, sodium, potassium, and chloride) showed no significant changes. Hematological analysis revealed a significant decrease in white blood cells and hemoglobin in the curative group, indicating bone marrow suppression. In contrast, the palliative group demonstrated stable white blood cell levels and increased platelet counts post-treatment.Conclusion: Radiotherapy affects biochemical and hematological parameters differently in curative and palliative settings. Personalized monitoring of these parameters is essential to mitigate complications and improve patient outcomes.
Sung H, Ferlay J, Siegel R L., Laversanne M., Soerjomataram I., Jemal A, et al (2021). Global Cancer Statistics: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia; International Agency for Research on Cancer, Lyon, France.
Baroudi H, Brock K K, Cao W, Chen X, Chung C, Court LC, et al (2023). Automated Contouring and Planning in Radiation Therapy: What Is ‘Clinically Acceptable Diagnostic; 13: 667.https://doi.org/ 10.3390/diagnostics13040667.
Skouboe S, Ravkilde T, Bertholet J, Hansen R, Worm ES, Muurholm CG, et al (2019). First clinical real-time motion-including tumor dose reconstruction during radiotherapy delivery. Radiother Oncol;139: 66-71. doi: 10.1016/j.radonc.2019.07.007.
Gianfaldoni S, Gianfaldoni R, Wollina U, Lotti J, Tchernev G, Lotti T (2017). An Overview on Radiotherapy: From Its History to Its Current Applications in Dermatology, kopje Republic of MacedoniaOpen Access Macedonian Journal of Medical Sciences; 5(4): 521 5. doi: 10.3889/ oamjms.2017.122.
Komorowska D, Radzik, T, Kalenik, S, Rodaka A (2022). A. Natural Radiosensitizers in Radiotherapy: Cancer Treatment by Combining Ionizing Radiation with Resveratrol. Int. J. Mol. Sci; 23: 10627. https:// doi.org/10.3390/ijms231810627.
Yosefof E, Kurman N, Yaniv D (2023). The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer. Cancers (Basel). 22;15(9):2408. doi: 10.3390/cancers15092408.
Quan EM, Li X, Li Y, Wang X, Kudchadker RJ, Johnson JL, et al (2012). A comprehensive comparison of IMRT and VMAT plan quality for prostate cancer treatment. Int J Radiat Oncol Biol Phys; 83: 1169-76. doi: 10.1016/j.ijrobp.2011.09.015.
Quirk S, Grendarova P, Roumeliotis M (2018). Five-field IMRT class solutions and dosimetric planning guidelines for implementing accelerated partial breast irradiation, Practical Radiation Oncology; 8; (3): 99-107.
May Zeki Saddik, Fatihea Fatihalla Hassan. Dosimetric comparison between intensity-modulated radiation therapy and volumetric-modulated arc therapy to enhance bladder and bowel. JOURNAL of MEDICINE and LIFE. VOL: 16 ISSUE: 9 SEPTEMBER 2023.
Jin F., Luo HL, Zhou J, He YN, Liu XF, Zhong MS, et a l (2018). Cancer risk assessment in modern radiotherapy works with medical big data. Cancer Manag Res; 10: 665.75, doi: 10.2147/CMAR.S164980
Redapi L, Rossi L, Marrazzo L, Penninkhof JJ, Pallotta S, Heijmen B, et al (2022). Comparison of volumetric modulated arc therapy and intensity-modulated radiotherapy for left-sided whole-breast irradiation using automated planning, Strahlenther Onkol; 198: 236–246, Italy. doi: 10.1007/s00066-021-01817-x.
Buwenge M, Scirocco E, Deodato F, Macchia G, Ntreta M, Bisello S, et al (2020). Radiotherapy of prostate cancer: impact of treatment characteristics
on the incidence of second tumors. BMC Cancer 20, 90. https://doi.org/10.1186/s12885-020-6581-5.
Nashwan K. Abdulkareem, Fatiheea F. Hassan. Half Beam Technique in Patients with Left Breast Cancer and Evaluate its Dosimetry Parameters from Dose-volume Histograms.Medico-legal Update, April-June 2020, Vol. 20, No. 2 ).
Ahmed n. Clinical biochemistry. Oxford University Press; 2016.
Mahendra a. An overview of electrolytes: their importance, function, and imbalances. Department of Public Health, Parul University, Vadodara, India. 2023 Mar 23.
Saillant a, try m, laparra a, lecoq al, zaidan m. Elec¬trolyte disorders in oncological patients. Bulletin du cancer. 2023 May 17: s0007-4551.
Prevarskaya n, skryma r, shuba y. Ion channels in cancer: are cancer hallmarks oncochannelopathies? Physiological reviews. 2018 apr 1;98(2):559 621.
Almuradova e, cicin i. Cancer-related hypercalcemia and potential treatments. Frontiers in endocrinology. 2023 Mar 22; 14:1039490.
Garraud o, tissot jd. Blood and blood components: from similarities to differences. Frontiers in medicine. 2018 Apr 9; 5:84.
Mahmood Sq, Talabany Bk, khoshnaw ns, Hamasoor T, Hussein Zs, Hassan M. Effects of radiotherapy on blood parameters in patients with different types of cancer; single center experience in Iraq. Iraqi journal of hematology. 2024 jan 1;13(1):90-4.
Costa, Reagan Mr. Therapeutic irradiation: consequences for bone and bone marrow adipose tissue. Frontiers in endocrinology. 2019 Aug 29; 10:587.
Swanson gp, Hammonds k, jhavar s. Reference re¬sults for blood parameter changes and recovery after pelvic radiation without chemotherapy. Hematology reports. 2022 may 12;14(2):155-64.
El dessouky ym, el dessouky mm, el batrawy oa. Penicillamine as radiation protector against gamma radiation effect on complete blood count parameters of guinea pigs. Al azhar assiut med j 2019; 17:145.
Fekete Z, Ignat P, Jakab H, Todor N, László IP, Muntean AS, Curcean S, Nemeș A, Nuțu D, Kacsó G. Serum Calcium Level at Diagnosis Can Predict Lethal Prostate Cancer Relapse. J Clin Med. 2024 Aug 16;13(16):4845. doi: 10.3390/jcm13164845.
Sequeira JP, Salta S, Freitas R, López-López R, Díaz- Lagares Á, Henrique R, Jerónimo C. Biomarkers for Pre-Treatment Risk Stratification of Prostate Cancer Patients: A Systematic Review. Cancers (Basel). 2024 Mar 30;16(7):1363. doi: 10.3390/cancers16071363. PMID: 324.
Mahal AR. Current and Emerging Standards in Radiation Therapy for Prostate Cancer | PER. American Journal of Hematology / Oncology®. 2017 Jun 20;13(6).
Numakura, K.; Kobayashi, M.; Muto, Y.; Sato, H.; Sekine, Y.; Sobu, R.; Aoyama, Y.; Takahashi, Y.; Okada, S.; Sasagawa, H.; et al. The Current Trend of Radiation Therapy for Patients with Localized Prostate Cancer. Curr. Oncol. 2023, 30, 8092–8110. https://doi. org/10.3390/ curroncol30090587.8611041; PMCID: PMC11011064.
Berk L. The effects of high-dose radiation therapy on bone: a scoping review. Radiat Oncol J. 2024;42(2):95- 103. doi:10.3857/roj.2023.00969
Costa S, Reagan MR. Therapeutic Irradiation: Consequences for Bone and Bone Marrow Adipose Tissue. Front Endocrinol (Lausanne). 2019;10:587. Published 2019 Aug 29. doi:10.3389/fendo.2019.00587
Almuradova E, Cicin I. Cancer-related hypercalcemia and potential treatments. Front Endocrinol (Lausanne). 2023 Mar 22;14:1039490. doi: 10.3389/ fendo.2023.1039490
Jasim A, Altememy D. Comparison of Chemotherapy Effectiveness Between Cancer Patients with and without Dependent Dose of Radiotherapy. Iran J War Public Health 2024; 16 (3) :289-294
Bartkiewicz P, Kunachowicz D, Filipski M, Stebel A, Ligoda J, Rembiałkowska N. Hypercalcemia in Cancer: Causes, Effects, and Treatment Strategies. Cells. 2024 Jun 18;13(12):1051. doi: 10.3390/ cells13121051 Xu H, Wang W, Liu X, Huang W, Zhu C, Xu Y, Yang H, Bai J, Geng D. Targeting strategies for bone diseases: signaling pathways and clinical studies. Signal Transduct Target Ther. 2023 May 17;8(1):202. doi: 10.1038/s41392-023-01467-8
Yan M, Gouveia AG, Cury FL, Moideen N, Bratti VF, Patrocinio H, Berlin A, Mendez LC, Moraes FY. Practical considerations for prostate hypofractionation in the developing world. Nature Reviews Urology. 2021 Nov;18(11):669-85.
Mahmood SQ, Talabany BK, Khoshnaw NS, Hamasoor T, Hussein ZS, Hassan M. Effects of radiotherapy on blood parameters in patients with different types of cancer; single center experience in Iraq. Iraqi Journal of Hematology. 2024 Jan 1;13(1):90-4.
Gao L, Zhang A. Low-dose radiotherapy affects the progression of anti-tumor response. Transl Oncol. 2023 Sep;35:101710. doi: 10.1016/j. tranon.2023.101710. Epub 2023 Jun 13. PMID: 37320873; PMCID: PMC10277580.
Zou, Q., Hong, W., Zhou, Y. et al. Bone marrow stem cell dysfunction in radiation-induced abscopal bone loss. J Orthop Surg Res 11, 3 (2016). https://doi. org/10.1186/s13018-015-0339-9.
Dania Dhafer Hameed1, Vyan Hussein Abdulhakeem2, Sura AbdulKareem Madlool3, Nabaa Mohammed Ali4, Duaa Ali Salih5, Fatima Jassim Mohammed5. “The Efficiency of Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) in Bone Marrow of Lumber Spinal Cord Tumor Radiotherapy.” Oncology and Radiotherapy, vol. 17, no. 9, 5 Sept. 2023.
Sherisse Ornella Hunte, Catharine H Clark, Nikolay Zyuzikov, Andrew Nisbet, Volumetric modulated arc therapy (VMAT): a review of clinical outcomes— what is the clinical evidence for the most effective implementation?, British Journal of Radiology, Volume 95, Issue 1136, 1 August 2022, 20201289, https://doi.org/10.1259/bjr.20201289.
Fischer-Valuck BW, Baumann BC, Apicelli A, Rao YJ, Roach M, Daly M, Dans MC, White P, Contreras J, Henke L, Gay H, Michalski JM, Abraham C. Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital-based analysis of patterns of care, RT fractionation scheme, and overall survival. Cancer Med. 2018 Sep;7(9):4240- 4250. doi: 10.1002/cam4.1655. Epub 2018 Aug 17. PMID: 30120817; PMCID: PMC6144149.
Baroudi H, Brock K K, Cao W, Chen X, Chung C, Court LC, et al (2023). Automated Contouring and Planning in Radiation Therapy: What Is ‘Clinically Acceptable Diagnostic; 13: 667.https://doi.org/ 10.3390/diagnostics13040667.
Skouboe S, Ravkilde T, Bertholet J, Hansen R, Worm ES, Muurholm CG, et al (2019). First clinical real-time motion-including tumor dose reconstruction during radiotherapy delivery. Radiother Oncol;139: 66-71. doi: 10.1016/j.radonc.2019.07.007.
Gianfaldoni S, Gianfaldoni R, Wollina U, Lotti J, Tchernev G, Lotti T (2017). An Overview on Radiotherapy: From Its History to Its Current Applications in Dermatology, kopje Republic of MacedoniaOpen Access Macedonian Journal of Medical Sciences; 5(4): 521 5. doi: 10.3889/ oamjms.2017.122.
Komorowska D, Radzik, T, Kalenik, S, Rodaka A (2022). A. Natural Radiosensitizers in Radiotherapy: Cancer Treatment by Combining Ionizing Radiation with Resveratrol. Int. J. Mol. Sci; 23: 10627. https:// doi.org/10.3390/ijms231810627.
Yosefof E, Kurman N, Yaniv D (2023). The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer. Cancers (Basel). 22;15(9):2408. doi: 10.3390/cancers15092408.
Quan EM, Li X, Li Y, Wang X, Kudchadker RJ, Johnson JL, et al (2012). A comprehensive comparison of IMRT and VMAT plan quality for prostate cancer treatment. Int J Radiat Oncol Biol Phys; 83: 1169-76. doi: 10.1016/j.ijrobp.2011.09.015.
Quirk S, Grendarova P, Roumeliotis M (2018). Five-field IMRT class solutions and dosimetric planning guidelines for implementing accelerated partial breast irradiation, Practical Radiation Oncology; 8; (3): 99-107.
May Zeki Saddik, Fatihea Fatihalla Hassan. Dosimetric comparison between intensity-modulated radiation therapy and volumetric-modulated arc therapy to enhance bladder and bowel. JOURNAL of MEDICINE and LIFE. VOL: 16 ISSUE: 9 SEPTEMBER 2023.
Jin F., Luo HL, Zhou J, He YN, Liu XF, Zhong MS, et a l (2018). Cancer risk assessment in modern radiotherapy works with medical big data. Cancer Manag Res; 10: 665.75, doi: 10.2147/CMAR.S164980
Redapi L, Rossi L, Marrazzo L, Penninkhof JJ, Pallotta S, Heijmen B, et al (2022). Comparison of volumetric modulated arc therapy and intensity-modulated radiotherapy for left-sided whole-breast irradiation using automated planning, Strahlenther Onkol; 198: 236–246, Italy. doi: 10.1007/s00066-021-01817-x.
Buwenge M, Scirocco E, Deodato F, Macchia G, Ntreta M, Bisello S, et al (2020). Radiotherapy of prostate cancer: impact of treatment characteristics
on the incidence of second tumors. BMC Cancer 20, 90. https://doi.org/10.1186/s12885-020-6581-5.
Nashwan K. Abdulkareem, Fatiheea F. Hassan. Half Beam Technique in Patients with Left Breast Cancer and Evaluate its Dosimetry Parameters from Dose-volume Histograms.Medico-legal Update, April-June 2020, Vol. 20, No. 2 ).
Ahmed n. Clinical biochemistry. Oxford University Press; 2016.
Mahendra a. An overview of electrolytes: their importance, function, and imbalances. Department of Public Health, Parul University, Vadodara, India. 2023 Mar 23.
Saillant a, try m, laparra a, lecoq al, zaidan m. Elec¬trolyte disorders in oncological patients. Bulletin du cancer. 2023 May 17: s0007-4551.
Prevarskaya n, skryma r, shuba y. Ion channels in cancer: are cancer hallmarks oncochannelopathies? Physiological reviews. 2018 apr 1;98(2):559 621.
Almuradova e, cicin i. Cancer-related hypercalcemia and potential treatments. Frontiers in endocrinology. 2023 Mar 22; 14:1039490.
Garraud o, tissot jd. Blood and blood components: from similarities to differences. Frontiers in medicine. 2018 Apr 9; 5:84.
Mahmood Sq, Talabany Bk, khoshnaw ns, Hamasoor T, Hussein Zs, Hassan M. Effects of radiotherapy on blood parameters in patients with different types of cancer; single center experience in Iraq. Iraqi journal of hematology. 2024 jan 1;13(1):90-4.
Costa, Reagan Mr. Therapeutic irradiation: consequences for bone and bone marrow adipose tissue. Frontiers in endocrinology. 2019 Aug 29; 10:587.
Swanson gp, Hammonds k, jhavar s. Reference re¬sults for blood parameter changes and recovery after pelvic radiation without chemotherapy. Hematology reports. 2022 may 12;14(2):155-64.
El dessouky ym, el dessouky mm, el batrawy oa. Penicillamine as radiation protector against gamma radiation effect on complete blood count parameters of guinea pigs. Al azhar assiut med j 2019; 17:145.
Fekete Z, Ignat P, Jakab H, Todor N, László IP, Muntean AS, Curcean S, Nemeș A, Nuțu D, Kacsó G. Serum Calcium Level at Diagnosis Can Predict Lethal Prostate Cancer Relapse. J Clin Med. 2024 Aug 16;13(16):4845. doi: 10.3390/jcm13164845.
Sequeira JP, Salta S, Freitas R, López-López R, Díaz- Lagares Á, Henrique R, Jerónimo C. Biomarkers for Pre-Treatment Risk Stratification of Prostate Cancer Patients: A Systematic Review. Cancers (Basel). 2024 Mar 30;16(7):1363. doi: 10.3390/cancers16071363. PMID: 324.
Mahal AR. Current and Emerging Standards in Radiation Therapy for Prostate Cancer | PER. American Journal of Hematology / Oncology®. 2017 Jun 20;13(6).
Numakura, K.; Kobayashi, M.; Muto, Y.; Sato, H.; Sekine, Y.; Sobu, R.; Aoyama, Y.; Takahashi, Y.; Okada, S.; Sasagawa, H.; et al. The Current Trend of Radiation Therapy for Patients with Localized Prostate Cancer. Curr. Oncol. 2023, 30, 8092–8110. https://doi. org/10.3390/ curroncol30090587.8611041; PMCID: PMC11011064.
Berk L. The effects of high-dose radiation therapy on bone: a scoping review. Radiat Oncol J. 2024;42(2):95- 103. doi:10.3857/roj.2023.00969
Costa S, Reagan MR. Therapeutic Irradiation: Consequences for Bone and Bone Marrow Adipose Tissue. Front Endocrinol (Lausanne). 2019;10:587. Published 2019 Aug 29. doi:10.3389/fendo.2019.00587
Almuradova E, Cicin I. Cancer-related hypercalcemia and potential treatments. Front Endocrinol (Lausanne). 2023 Mar 22;14:1039490. doi: 10.3389/ fendo.2023.1039490
Jasim A, Altememy D. Comparison of Chemotherapy Effectiveness Between Cancer Patients with and without Dependent Dose of Radiotherapy. Iran J War Public Health 2024; 16 (3) :289-294
Bartkiewicz P, Kunachowicz D, Filipski M, Stebel A, Ligoda J, Rembiałkowska N. Hypercalcemia in Cancer: Causes, Effects, and Treatment Strategies. Cells. 2024 Jun 18;13(12):1051. doi: 10.3390/ cells13121051 Xu H, Wang W, Liu X, Huang W, Zhu C, Xu Y, Yang H, Bai J, Geng D. Targeting strategies for bone diseases: signaling pathways and clinical studies. Signal Transduct Target Ther. 2023 May 17;8(1):202. doi: 10.1038/s41392-023-01467-8
Yan M, Gouveia AG, Cury FL, Moideen N, Bratti VF, Patrocinio H, Berlin A, Mendez LC, Moraes FY. Practical considerations for prostate hypofractionation in the developing world. Nature Reviews Urology. 2021 Nov;18(11):669-85.
Mahmood SQ, Talabany BK, Khoshnaw NS, Hamasoor T, Hussein ZS, Hassan M. Effects of radiotherapy on blood parameters in patients with different types of cancer; single center experience in Iraq. Iraqi Journal of Hematology. 2024 Jan 1;13(1):90-4.
Gao L, Zhang A. Low-dose radiotherapy affects the progression of anti-tumor response. Transl Oncol. 2023 Sep;35:101710. doi: 10.1016/j. tranon.2023.101710. Epub 2023 Jun 13. PMID: 37320873; PMCID: PMC10277580.
Zou, Q., Hong, W., Zhou, Y. et al. Bone marrow stem cell dysfunction in radiation-induced abscopal bone loss. J Orthop Surg Res 11, 3 (2016). https://doi. org/10.1186/s13018-015-0339-9.
Dania Dhafer Hameed1, Vyan Hussein Abdulhakeem2, Sura AbdulKareem Madlool3, Nabaa Mohammed Ali4, Duaa Ali Salih5, Fatima Jassim Mohammed5. “The Efficiency of Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) in Bone Marrow of Lumber Spinal Cord Tumor Radiotherapy.” Oncology and Radiotherapy, vol. 17, no. 9, 5 Sept. 2023.
Sherisse Ornella Hunte, Catharine H Clark, Nikolay Zyuzikov, Andrew Nisbet, Volumetric modulated arc therapy (VMAT): a review of clinical outcomes— what is the clinical evidence for the most effective implementation?, British Journal of Radiology, Volume 95, Issue 1136, 1 August 2022, 20201289, https://doi.org/10.1259/bjr.20201289.
Fischer-Valuck BW, Baumann BC, Apicelli A, Rao YJ, Roach M, Daly M, Dans MC, White P, Contreras J, Henke L, Gay H, Michalski JM, Abraham C. Palliative radiation therapy (RT) for prostate cancer patients with bone metastases at diagnosis: A hospital-based analysis of patterns of care, RT fractionation scheme, and overall survival. Cancer Med. 2018 Sep;7(9):4240- 4250. doi: 10.1002/cam4.1655. Epub 2018 Aug 17. PMID: 30120817; PMCID: PMC6144149.
| Files | ||
| Issue | Vol 16 No 1 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/bccr.v16i1.18756 | |
| Keywords | ||
| Prostate cancer radiotherapy electrolytes hematological parameters curative treatment palliative care | ||
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How to Cite
1.
Mikaeel Mustafa A, Fatihalla Hassan F. Impact of Radiotherapy on Electrolyte and Hematological Parameters in Prostate Cancer: Curative vs. Palliative Groups. Basic Clin Cancer Res. 2025;16(1):38-49.
