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Objective: The aim of this study was to compare bone marrow-sparing intensity-modulated radiotherapy (IMRT) with IMRT without entering pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods: For a cohort of 10 patients, bone marrow-sparing IMRT and routine IMRT planning were designed. The prescribed dose was 45 Gy/1.8 Gy/25f, 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system (TPS) using convolution/superimposition (CS) algorithm. Plans were compared according to dose-volume histogram (DVH) analysis in terms of planning target volume (PTV) homogeneity and conformity indices (HI and CI) as well as organs at risk (OARs) dose and volume parameters. Results: Bone marrow-sparing IMRT had an vantages over routine IMRT in terms of CI, but inferior to the latter for HI. Compared with routine IMRT, V5, V10, V20, V30, V40 of pelvic bone marrow of bone marrow-sparing IMRT reduced by 1.81%, 8.61%, 31.81%, 29.50%, 28.29%, respectively. No statistically significant differences were observed between bone marrow-sparing IMRT and routine IMRT in terms of small bowel, bladder and rectum. Conclusion: For patients with cervical cancer after hysterectomy, bone marrow-sparing IMRT reduced the pelvic bone marrow volume irradiated at all dose levels and might be conducive to preventing the occurrence of acute bone marrow toxicity.
Objective: The aim of this study was to compare bone marrow-sparing intensity-modulated radiotherapy (IMRT) with IMRT without entering pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods: For a cohort of 10 patients, bone marrow-sparing IMRT and routine IMRT planning were designed. The prescribed dose was 45 Gy / 1.8 Gy / 25f, 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system (TPS) using convolution / superimposition (CS) algorithm. Plans were compared according to dose-volume histogram (DVH) analysis in terms of planning target volume (PTV) homogeneity and conformity indices (HI and CI) as well as organs at risk (OARs) dose and volume parameters. Results: Bone marrow-sparing IMRT had an vantage over routine IMRT in terms of CI, but inferior to the latter for HI. Compared with routine IMRT, V5, V10, V20, V30, V40 of pelvic bone marrow of bone marrow- sparing ImgT reduced by 1.81%, 8.61%, 31.81%, 29.50%, 28.29%, respectively. No statistically significant differences were observed between bone marrow-sparing IMRT and routine IMRTs in terms of small bowel, bladder and rectum. Conclusion: For patients with cervical cancer after hysterectomy, bone marrow-sparing IMRT reduced the pelvic bone marrow volume irradiated at all dose levels and might be conducive to preventing the occurrence of acute bone marrow toxicity.