Comparison of IMRT Plans with and Without Bone Marrow Sparing For the Treatment of Cervical Cancer

Document Type : Original Paper


1 Department of Radiotherapy, MNJ Institute of Oncology & Regional Cancer Centre,Hyderabad-500004,Telangana,INDIA

2 Department of Radiotherapy, MNJ Institute of Oncology & Regional Cancer Centre, Hyderabad-500004, Telangana,INDIA


Introduction: The present study aimed to compare plans with Bone Marrow sparing (BM-IMRT) and without Bone Marrow Sparing (N-IMRT).
Material and Methods: Fifteen cases of cervical cancer cases were selected for retrospective study. All the cases were previously treated with normal IMRT. For this study, plans with BM-IMRT were created again for all patients following RTOG guidelines. The prescribed dose of 50Gy in 25 fractions was given. The plan having coverage of 95% of PTV receiving 95% of the prescribed dose was accepted. The plans were compared based on PTV coverage (dose to 2%, 98% of target); constraints of OARs (Organs at Risk) were the volume of 40% < 40Gy for normal bladder and rectum (volume receiving dose 5Gy) V5<95%, V10<80%, V20<60%, V30<50% and V40<35% respectively for Bone marrow and lowest possible doses to bowel were given for planning criteria. Apart from this, HI, CI and R50% were also calculated concerning PTV coverage to analyze plan quality.
Results: There was a statistical difference in P-values of D2, D98, TV95, HI, R50% but the actual difference is less than 2%. In the case of OARs, there were also significant differences in statistical as well longitudinal in values of V10, V20, V30 and V40 of Bone Marrow (P<0.01) and there was only statistical differences (p<0.05) at V50 of bladder and rectum.
Conclusion: Without scarifying dose coverage for planning target volume, bone marrow can be spared while treating cervical cancer patients using IMRT technique with bone marrow as an extra constraint.


Main Subjects

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Volume 18, Issue 6
November and December 2021
Pages 409-413
  • Receive Date: 23 August 2020
  • Revise Date: 10 December 2020
  • Accept Date: 15 December 2020