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

Objective To compare the dose -volume histogram analysis and toxicities of bone marrow-sparing volumetric-modulated arc-radiation therapy or without an intention of avoiding bone marrow for postoperative cervical cancer,and to explore the necessity of bone marrow-sparing. Methods The 52 subjects underwent radical hysterectomy and pelvic lymphadenectomy and postoperative radiation therapy for early-stage high-risk cervical carcinoma from June,2016 to January,2017 were divided into BMS-VMAT group and VMAT group randomly,pelvic bone was contoured instead of bone marrow in the BMS-VMAT group.All patients carried a week concurrently cisplatin chemotherapy with radiotherapy.We compared the PTV uniformity coefficient(HI),conformity index(CI) and other pelvic organs of the two groups,also including their hematologic toxicities,the toxicity of gastrointestinal tract and urinary system. Results All patients completed the treatment.There are no statistically significant differences between two groups for the HI(P=0.529).BMS-VMAT group has a less probability on CI(P<0.001) and hematologic toxicities(P<0.001),the other toxicities reaction are similar(P>0.05). Conclusion Bone marrow-sparing volumetric-modulated arc-radiation therapy for postoperative cervical cancer has less probability on hematologic toxicities,the other toxicities reaction are not different.We suggest the pelvis as a conventional organ to limit the dose.