Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation
Introduction: Concurrent Chemoradiation (CRT) is the standard of care for locally advanced cervical cancer patients. Addition of chemotherapy to pelvic radiotherapy augments Haematological Toxicity (HT). Whether reducing the radiation dose to Bone Marrow (BM) will diminish HT is yet not clear. Aim:...
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JCDR Research and Publications Private Limited
2019-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/12745/39841_CE[Ra1]_F(AC)_PF1(AGAK)_PFA(AK)_PB(NC_AG)_PN(SL).pdf |
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| author | Neha Gupta Chandra Prakash Kalpak Chakrabarty Upendra Giri Ankita Patel Sunil Choudhary |
| author_facet | Neha Gupta Chandra Prakash Kalpak Chakrabarty Upendra Giri Ankita Patel Sunil Choudhary |
| author_sort | Neha Gupta |
| collection | DOAJ |
| description | Introduction: Concurrent Chemoradiation (CRT) is the standard of care for locally advanced cervical cancer patients. Addition of chemotherapy to pelvic radiotherapy augments Haematological Toxicity (HT). Whether reducing the radiation dose to Bone Marrow (BM) will diminish HT is yet not clear. Aim: The purpose of the present study was to analyse the feasibility of Bone Marrow Sparing (BMS) in cervical cancer patients using Intensity Modulated Radiotherapy (IMRT). Materials and Methods: Computed Tomography (CT) images of 10 consecutive biopsy-proven invasive cervical cancer patients were used. All patients were treated using Intensity Modulated Radiotherapy (IMRT) without bone marrow sparing (normal-IMRT). BMS-IMRT plans were generated for this study and Dose-Volume Histogram (DVH) parameters were then compared with normal-IMRT plans. Results: The mean values of the Planning Target Volume (PTV) V95 and V97 were lower and were statistically significant (p=0.016 and 0.019 respectively) in BMS-IMRT when compared to normal-IMRT, however, PTV coverage was not compromised in any BMS-IMRT plan. There was no statistically significant difference in the mean values of rectum V30, V40, bowel V35, V40, V45, and femoral head V35. However, the mean values of rectum V50, bladder V40, V45, and V50 were statistically lower in the case of BMS-IMRT. When compared to normal-IMRT the mean values of Pelvic Bone Marrow (PBM) V10, V20, V30, V40 were lower and found to be statistically significant in BMSIMRT. Conclusion: The BMS-IMRT spares the PBM without compromising the target volume and at the same time spares bladder and rectum more effectively. |
| first_indexed | 2024-12-13T09:47:56Z |
| format | Article |
| id | doaj.art-c41c54d86a47453e9ca9143dfd9b5028 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-13T09:47:56Z |
| publishDate | 2019-04-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-c41c54d86a47453e9ca9143dfd9b50282022-12-21T23:52:00ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2019-04-01134XC01XC0510.7860/JCDR/2019/39841.12745Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric EvaluationNeha Gupta0Chandra Prakash1Kalpak Chakrabarty2Upendra Giri3Ankita Patel4Sunil Choudhary5Consultant, Department of Radiation Oncology, Apex Hospital Cancer Institute, Varanasi, Uttar Pradesh, India.Consultant, Department of Radiation Oncology, Apex Hospital Cancer Institute, Varanasi, Uttar Pradesh, India.Medical Physicist, Department of Radiation Oncology, Apex Hospital Cancer Institute, Varanasi, Uttar Pradesh, India.Medical Physicist, Department of Radiation Oncology, Apex Hospital Cancer Institute, Varanasi, Uttar Pradesh, India.Consultant, Department of Radiation Oncology, Apex Hospital Cancer Institute, Varanasi, Uttar Pradesh, India.Associate Professor, Department of Radiation Oncology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India.Introduction: Concurrent Chemoradiation (CRT) is the standard of care for locally advanced cervical cancer patients. Addition of chemotherapy to pelvic radiotherapy augments Haematological Toxicity (HT). Whether reducing the radiation dose to Bone Marrow (BM) will diminish HT is yet not clear. Aim: The purpose of the present study was to analyse the feasibility of Bone Marrow Sparing (BMS) in cervical cancer patients using Intensity Modulated Radiotherapy (IMRT). Materials and Methods: Computed Tomography (CT) images of 10 consecutive biopsy-proven invasive cervical cancer patients were used. All patients were treated using Intensity Modulated Radiotherapy (IMRT) without bone marrow sparing (normal-IMRT). BMS-IMRT plans were generated for this study and Dose-Volume Histogram (DVH) parameters were then compared with normal-IMRT plans. Results: The mean values of the Planning Target Volume (PTV) V95 and V97 were lower and were statistically significant (p=0.016 and 0.019 respectively) in BMS-IMRT when compared to normal-IMRT, however, PTV coverage was not compromised in any BMS-IMRT plan. There was no statistically significant difference in the mean values of rectum V30, V40, bowel V35, V40, V45, and femoral head V35. However, the mean values of rectum V50, bladder V40, V45, and V50 were statistically lower in the case of BMS-IMRT. When compared to normal-IMRT the mean values of Pelvic Bone Marrow (PBM) V10, V20, V30, V40 were lower and found to be statistically significant in BMSIMRT. Conclusion: The BMS-IMRT spares the PBM without compromising the target volume and at the same time spares bladder and rectum more effectively.https://jcdr.net/articles/PDF/12745/39841_CE[Ra1]_F(AC)_PF1(AGAK)_PFA(AK)_PB(NC_AG)_PN(SL).pdfcervical cancerhaematological toxicitypelvic bone marrowvolumetric modulated arc radiotherapy |
| spellingShingle | Neha Gupta Chandra Prakash Kalpak Chakrabarty Upendra Giri Ankita Patel Sunil Choudhary Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation Journal of Clinical and Diagnostic Research cervical cancer haematological toxicity pelvic bone marrow volumetric modulated arc radiotherapy |
| title | Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation |
| title_full | Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation |
| title_fullStr | Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation |
| title_full_unstemmed | Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation |
| title_short | Potential Advantages of Bone Marrow Sparing IMRT in Cancer Cervix: A Dosimetric Evaluation |
| title_sort | potential advantages of bone marrow sparing imrt in cancer cervix a dosimetric evaluation |
| topic | cervical cancer haematological toxicity pelvic bone marrow volumetric modulated arc radiotherapy |
| url | https://jcdr.net/articles/PDF/12745/39841_CE[Ra1]_F(AC)_PF1(AGAK)_PFA(AK)_PB(NC_AG)_PN(SL).pdf |
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