Introduction/Background Cervical cancer is the 4th most common cancer in women with most of them needing pelvic chemoradiation. This study compared bone marrow sparing intensity modulated radiotherapy (BMS-IMRT) with bone marrow sparing IMRT arc therapy (BMS-Rapid Arc) in reducing grade 2 or higher hematological toxicity in cervical cancer patients treated with concurrent chemoradiotherapy.
Methodology 24 cervix cancer patients with stage Ib2-IIIb were equally divided between BMS-IMRT group and BMS-Rapid Arc group. All patients received external beam radiation of 50 Gy in 25 fractions with concurrent weekly cisplatin. Baseline hematologic parameters were evaluated before radiation and every week during external beam radiation. The endpoint of the trial was grade 2 or higher acute hematological toxicity, measured by CTCAE version 5.0
Results 24 patients were enrolled with 12 patients in each group. Both groups had witnessed 50% (6 out of 12) chance of developing grade 2 or higher hematological toxicity. Mean bone marrow dose was 26.9 Gy in BMS-IMRT group and 26.1 Gy in BMS-Rapid Arc group.
Conclusion The risk of developing grade 2 or higher acute hematological toxicity in cancer cervix patients undergoing chemoradiation remains similar in both BMS-IMRT and BMS-Rapid Arc groups. However, mean bone marrow dose achieved in BMS-Rapid Arc plan is lower compared to BMS-IMRT. The other important point, cisplatin also contributes to hematological toxicity.
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