ZHU Li-hong,SU Xing,WU Hao,et al.Dosimetry of bone marrow irradiated by intensity modulated whole pelvis radiotherapy for cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2008,28(1):57-60
Dosimetry of bone marrow irradiated by intensity modulated whole pelvis radiotherapy for cervical cancer
Received:May 26, 2007  
DOI:
KeyWords:IMRT  Pelvic bone marrow  Cervical cancer  Hematologic toxicity
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Author NameAffiliationE-mail
ZHU Li-hong 100036 北京大学临床肿瘤学院北京肿瘤医院放疗科  
SU Xing 100036 北京大学临床肿瘤学院北京肿瘤医院放疗科  
WU Hao 100036 北京大学临床肿瘤学院北京肿瘤医院放疗科  
韩树奎 100036 北京大学临床肿瘤学院北京肿瘤医院放疗科  
王俊杰 Cancer Center, Peking University Third Hospital, Beijing, 100083, China  
徐博 100036 北京大学临床肿瘤学院北京肿瘤医院放疗科 fangliaoxubo@vip.sina.com 
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Abstract::
      Objective To assess the effect of applying intensity modulated whole pelvis radiotherapy(IM-WPRT) on reducing the irradiated volume of pelvic bone marrow (BM).Methods 15 consecutive patients with cervical cancer underwent IM-WPRT. The clinical target volume(CTV) and the planning target volume (PTV=CTV+1.0 cm) and pelvic BM were contoured. Two plans were created for each patient: an IM-WPRT treatment plan (excluding pelvic BM), and a pelvic BM-sparing (BMS) IM-WPRT plan. Dose-volume histograms for the PTV and critical organs were evaluated.Results BMS IM-WPRT treatment plans demonstrated a significant reduction of the volume of pelvic BM at various dose levels, especially at 20-50Gy(P≤0.008).Compared with the conventional IM-WPRT, BMS IM-WPRT decreased the BM volume by 6.5% and 8.8% at 80% and 100% of the prescription dose,respectively. Furthermore, the BMS IM-WPRT plans,with adequate coverage and the same dose homogeneity of PTV, resulted in significant sparing of other critical organs.Conclusions BMS IM-WPRT is superior to pelvic BM. It provides dosimetric evidence of reducing hematologic toxicity of concurrent radiochemotherapy in locally advanced cervical cancer.
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