A methodology for incorporating functional bone marrow sparing in IMRT planning for pelvic radiation therapy

McGuire, Sarah; Menda, Yusuf; Ponto, Laura L. Boles; Gross, B.; Juweid, Malik E.; Bayouth, John E.

doi:10.1016/j.radonc.2011.01.025

Cited by 43 publications

(42 citation statements)

References 18 publications

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“…One major side effect of many cancer treatments is bone marrow suppression. 18 F-FLT uptake has been shown to decrease after radiation, especially in areas with active marrow, including the skull and pelvis (15)(16)(17). In patients undergoing radiation treatment, both the profile and the individual vertebral data have shown a strong correlation between change in 18 F-FLT uptake and radiation dose.…”

Section: Bone Marrow and Hematologic Malignanciesmentioning

confidence: 99%

PET Imaging of Proliferation with Pyrimidines

Tehrani

Shields

2013

J Nucl Med

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Section: Bone Marrow and Hematologic Malignanciesmentioning

confidence: 99%

PET Imaging of Proliferation with Pyrimidines

Tehrani

Shields

2013

J Nucl Med

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“…Several dosimetric and clinical studies have demonstrated the benefit of this technique, especially for the treatment of concave volumes, as in the case of pelvic tumours. [13][14][15][16] Gynaecological and gastrointestinal tumours correspond to different treatment volumes and radiation doses, which may account for variations in the incidence of PIF.…”

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confidence: 99%

Pelvic insufficiency fracture (PIF) incidence in patients treated with intensity-modulated radiation therapy (IMRT) for gynaecological or anal cancer: single-institution experience and review of the literature

Bazire

Foy

et al. 2017

BJR

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Objective: To summarize the results of pelvic insufficiency fracture (PIF) incidence in patients with anal or gynaecological cancer treated by pelvic intensitymodulated radiation therapy (IMRT). Methods: The clinical and morphological (CT and/or pelvic MRI) characteristics of patients treated by IMRT at our institution between 2007 and 2014 were analyzed. The global incidence of PIF after external beam radiotherapy and the impact of tumour site (gynaecological or anal cancer) were determined. A dosimetric study was then performed to compare patients with and without pelvic fracture. Results: 341 patients were treated by IMRT for gynaecological or anal cancer between 2007 and 2014. 15 patients experienced at least 1 pelvic fracture after external beam radiotherapy, corresponding to an overall incidence of 4.4%. Age and menopausal status were correlated with an increased fracture risk (p 5 0.0274 and p , 0.0001, respectively). The site of the primary tumour (gynaecological or anal canal) was not associated with an excess fracture risk. The median maximum dose received at the fracture site was 50.3 Gy (range: 40.8-68.4 Gy). Conclusion: The incidence of pelvic fracture after IMRT is low, but is higher after the age of 50 and in patients who are postmenopausal. Pre-treatment evaluation of bone density by bone densitometry and phosphorus-calcium assessment could be useful prior to the management of these patients. Advances in knowledge: Pelvic fractures are a frequent complication after radiotherapy. The influence of IMRT and clinical characteristics were evaluated in this study.

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“…Mell et al [18] report a decrease of haematological toxicity after reducing the dose delivered to the bone marrow for patients with rectal cancer. The ability to isolate the structure of bone marrow using PET for patients with gynaecological diseases was analysed by McGuire et al [19]. The active bone marrow was regarded as an important critical organ.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Poncyljusz

Kukołowicz

Chorąży

et al. 2017

Nowotwory. Journal of Oncology

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Background. Irradiation of a larger volume of the target may lead to an increase of the doses delivered to the surrounding organs at risk (OAR) for post-prostatectomy patients with a higher risk of nodal involvement. It was anticipated that IMRT significantly improved OAR sparing. The aim of this study was to provide a dosimetric comparison between conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) treatment plans for patients with prostate cancer irradiated to the prostate bed and pelvic lymph-nodal area. Materials and methods. The 3D-CRT and IMRT plans were created for ten patients after prostatectomy. The treatment plans were generated for the prostate bed (PTV1) and the pelvic lymph nodes (PTV2). The sum of PTV1 and PTV2 was irradiated to a mean dose of 46 Gy in 23 fractions, and additionally PTV1 was irradiated to a mean dose of 18 Gy in 9 fractions. Target coverage and the doses delivered to the pelvic bones, the rectum, the bladder, the bowel bag, and the femurs, were compared between techniques. The Wilcoxon signed-rank test was used to compare the dosimetric parameters. Results. The dosimetric quality of 3D-CRT and IMRT plans were comparable for target coverage (the mean value of PTV1 V95%, the mean value of PTV2 V95% all > 99%). The IMRT plans resulted in significant reductions in the pelvic bones Conclusions. The analysis presented in this paper demonstrates that the IMRT technique reduces the delivered dose to the OARs. Most interesting was the possibility of reducing the delivered dose to the pelvic bones and the bowel bag. This allowed us to expect a decreased risk of acute hematologic toxicity and acute gastrointestinal toxicity. NOWOTWORY J Oncol 2016; 66, 6: 440-444

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A methodology for incorporating functional bone marrow sparing in IMRT planning for pelvic radiation therapy

Cited by 43 publications

References 18 publications

PET Imaging of Proliferation with Pyrimidines

PET Imaging of Proliferation with Pyrimidines

Pelvic insufficiency fracture (PIF) incidence in patients treated with intensity-modulated radiation therapy (IMRT) for gynaecological or anal cancer: single-institution experience and review of the literature

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

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