Dosimetric Evaluation of TomoTherapy based Whole Pelvic Intensity Modulated Radiation Therapy with and without Bone Marrow Sparing in Gynecologic Cancers

Abstract

Pelvic radiation therapy with concurrent chemotherapy is the standard of care for locally advanced cervical carcinoma. While effective, this treatment approach is associated with acute hematologic toxicity. Published literature reports that pelvic bone marrow (BM) dosimetric parameters of V10>90%, V10>85%, and V20>80% are associated with higher rates of hematologic toxicity. In this study, we sought to investigate the ability of TomoTherapy based BM sparing intensity modulated radiation therapy (BMS-IMRT) in reducing dose to the pelvic BM while evaluating the dose distribution to nearby critical structures and effect on PTV coverage.