Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer: A Comparison of 3DCRT, IMRT, and RapidARC

Abstract

This study suggests that IMRT results in milder hematological toxicity than either 3DCRT or RapidARC. Dosimetric parameters were associated with the incidence of HT in cervical cancer patients who received concurrent chemoradiotherapies.

Modulating Both Tumor Cell Death and Innate Immunity Is Essential for Improving Radiation Therapy Effectiveness

“…This is in particular the case when radiation therapy is delivered to pelvis such as for cervical cancer, rectal cancer and prostate cancer, during which a large proportion of bone marrow is affected (154). Neutrophils are the major innate immune cells that are decreased by radiation therapy.…”

Bone marrow sparing RT in era of immunotherapy

“…Approximately half (40-50%) of bone marrow is localized in pelvic region [47,48]. Majority of available clinical data describes the application of intensity modulated radiation therapy (IMRT) for BMS-RT for prostate, cervical, rectum, anal cancers [47,[49][50][51][52][53][54][55][56][57][58]. In macroscopic cervical and rectum cancer dynamic irradiation techniques are still not first-line treatment options due to concerns over internal organ motion [8,9,59].…”

“…In another paper, Wan et al indicated that lumbosacral BM-V40 predicted grade ≤ 2 HT in CRT for rectal cancer [54]. In the study including 100 women, Chang et al noted that IMRT was superior to 3-D RT in medium and high doses (BM-V20, BM-V30, BM-V40) and mean BM dose [55]. Those parameters were most significant for HT in CRT for cervical cancer [55].…”

“…In the study including 100 women, Chang et al noted that IMRT was superior to 3-D RT in medium and high doses (BM-V20, BM-V30, BM-V40) and mean BM dose [55]. Those parameters were most significant for HT in CRT for cervical cancer [55]. Noteworthy RapidArc plans presented higher mean BM dose, BM-V10 and BM-V40 than IMRT [55].…”

“…Those parameters were most significant for HT in CRT for cervical cancer [55]. Noteworthy RapidArc plans presented higher mean BM dose, BM-V10 and BM-V40 than IMRT [55]. In the biggest study including 121 chemonaïve prostate cancer patients, Sini et al demonstrated that BM-V40 predicted acute grade 3 and late grade 2 lymphopenia [24].…”