Optimal dose limitation strategy for bone marrow sparing in intensity-modulated radiotherapy of cervical cancer

Radiation Oncology
Zhirong BaoConghua Xie

Abstract

To quantify the dosimetric parameters of different bone marrow sparing strategies and to determine the optimal strategy for cervical cancer patients undergoing postoperative intensity-modulated radiotherapy (IMRT). Fifteen patients with cervical cancer were selected for analysis. The planning target volume (PTV) and the organs at risks (OAR) including small bowel, bladder, rectum, femoral heads, os coxae (OC), lumbosacral spine (LS) and bone marrow (BM) were contoured. For each patient, four IMRT plans with different strategies were generated, including one plan without BM as the dose-volume constraint, namely IMRT (N) plan, and three bone marrow sparing (BMS-IMRT) plans. The three BMS-IMRT plans used the BM, OC, OC and LS respectively, as the BM OAR, namely as IMRT (BM), IMRT (OC) and IMRT (OC + LS) plans. Dose volumes for the target and the OARs were compared using analysis of variance (ANOVA). Compared with IMRT (N) plans, the dose to the small bowel, bladder, rectum and femoral heads showed no increase in the three BMS-IMRT plans. However, the irradiated dose to BM, OC and LS significantly decreased. In particular, the mean dose of BM, OC and LS decreased by about 5Gy (p < 0.05) in IMRT (BM) plans while the average volume r...Continue Reading

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Citations

Dec 29, 2020·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·L Kuntz, G Noel
Sep 29, 2020·Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznań and Polish Society of Radiation Oncology·James M JuricaAndrew M Farach
Nov 1, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Pixiao ZhouShuxu Zhang

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