Clinical study of acute toxicity of pelvic bone marrow-sparing intensity-modulated radiotherapy for cervical cancer

Ginekol Pol. 2023;94(2):101-106. doi: 10.5603/GP.a2021.0234. Epub 2022 Feb 14.


Objectives: To compare the dose volume of the target area and the toxicity of pelvic bone marrow-sparing intensity-modulated radiotherapy (PBMS-IMRT) with routine IMRT in patients undergoing radiochemotherapy for cervical cancer.

Material and methods: Forty patients with indications for adjuvant radiochemotherapy after cervical cancer surgery were selected and randomly divided into IMRT (n = 20) and PBMS-IMRT (n = 20) groups to observe and record the toxicity and its severity in the blood, gastrointestinal tract, and genitourinary system.

Results: There was no significant difference in the target area conformity index (CI) or homogeneity index (HI) between the two groups (p > 0.05). The pelvic bone V10-V50 in the PBMS-IMRT group were lower than those in the IMRT group (p < 0.05), and there was lower hematological toxicity (p < 0.05) and fewer delays or interruptions in chemotherapy and/or radiotherapy (p < 0.05) in the PBMS-IMRT group. The toxicity to the gastrointestinal and genitourinary systems in the two groups was not significantly different (p > 0.05).

Conclusions: PBMS-IMRT significantly reduced the dose volume of the pelvic bone marrow, thereby reducing the incidence of bone marrow suppression. However, it had no significant impact on the gastrointestinal or genitourinary systems.

Keywords: cervical cancer; confined pelvic bone marrow; intensity-modulated radiotherapy; toxicity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bone Marrow
  • Chemoradiotherapy, Adjuvant
  • Female
  • Humans
  • Pelvic Bones*
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated* / adverse effects
  • Uterine Cervical Neoplasms* / drug therapy
  • Uterine Cervical Neoplasms* / radiotherapy