Fuli Zhang,Xu Weidong,Jiang Huayong,Wang Yadi,Junmao Gao,Qingzhi Liu,Na Lu,Diandian Chen,Bo Yao,Jianping Chen,Heliang He. Dosimetric analysis of tomotherapy-based intensity-modulated radiotherapy with and without bone marrow sparing for treatment of cervical cancer. Oncol Transl Med, 2015, 1: 135-139.
Dosimetric analysis of tomotherapy-based intensity-modulated radiotherapy with and without bone marrow sparing for treatment of cervical cancer
Received:December 04, 2014  Revised:May 19, 2015
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KeyWord:cervical neoplasm; helical tomotherapy; intensity-modulated radiotherapy (IMRT); dosimetry
Author NameAffiliationE-mail
Fuli Zhang Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng radiozfli@163.com 
Xu Weidong Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng  
Jiang Huayong Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng  
Wang Yadi Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Junmao Gao Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Qingzhi Liu Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Na Lu Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Diandian Chen Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Bo Yao Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Jianping Chen Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
Heliang He Radiation Oncology Department,The Military General Hospital of Beijing PLA,No. 5,Nanmencang,Dongcheng wangyadi@hotmail.com 
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Abstract:
      Objective The aim of the study was to compare tomotherapy-based bone marrow-sparing intensity-modulated radiotherapy (BMS-IMRT) with intensity-modulated radiotherapy (IMRT) without entering the pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods BMS-IMRT and IMRT plans were designed for a cohort of nine patients. The prescribed dose was 45 Gy in 1.8 Gy daily fractions, and 95% of the planned target volume received this dose. The doses were computed using a commercially available treatment planning system with the convolution/superposition algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices (HI and CI) as well as organ at risk dose and volume parameters. Results BMS-IMRT had advantages over IMRT in terms of CI, but was equivalent to the latter in HI. V5, V10, V20, V30, and V40 of pelvic bone marrow in BMS-IMRT decreased by 0.06%, 17.33%, 22.19%, 13.85%, and 16.46%, respectively, compared with IMRT. Except for V30 of the small bowel and V30 and V40 of the bladder, no statistically significant differences were found between BMS-IMRT and IMRT in the small bowel, bladder, and rectum. Conclusion For cervical cancer patients receiving tomotherapy-based radiotherapy after hysterectomy, BMS-IMRT reduced pelvic bone marrow volume receiving low-dose radiation, and it may be conducive to preventing acute hematologic toxicity
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