Clinical study of bone marrow-sparing intensity-modulated radiation therapy for postoperative cervical cancer

Abstract

Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy(BMS-IMRT) for postoperative cervical cancer. Methods From January 2011 to June 2012, totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly. External whole pelvic intensity-modulated irradiation combined with chemotherapy was carried out for all patients. The planning target volume received a dose of 45 Gy/25 fractions in all patients. Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group: the pelvis V30≤50%. All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy. Results Treatment was completed in 67 patients, as the other 3 patients stopped chemotherapy because of myelosuppression. There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS), alimentary tract toxicity and urinary toxicity. IMRT group had more serious hematologic toxicity than BMS-IMRT group, with statistically significant difference (χ2=14.355, P<0.05). Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy, IMRT group has more serious hematologic toxicity than BMS-IMRT group. The short-term effect and other toxicities reaction are similar between two groups. Key words: Cervical cancer; Bone marrow-sparing; Intensity-modulated radiation therapy; Toxicity reaction