Journal article
Prospective study of functional bone marrow-sparing intensity modulated radiation therapy with concurrent chemotherapy for pelvic malignancies
International journal of radiation oncology, biology, physics, v 85(2), pp 406-414
01 Feb 2013
PMID: 22687195
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To test the hypothesis that intensity modulated radiation therapy (IMRT) can reduce radiation dose to functional bone marrow (BM) in patients with pelvic malignancies (phase IA) and estimate the clinical feasibility and acute toxicity associated with this technique (phase IB).
We enrolled 31 subjects (19 with gynecologic cancer and 12 with anal cancer) in an institutional review board-approved prospective trial (6 in the pilot study, 10 in phase IA, and 15 in phase IB). The mean age was 52 years; 8 of 31 patients (26%) were men. Twenty-one subjects completed (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) simulation and magnetic resonance imaging by use of quantitative IDEAL (IDEAL IQ; GE Healthcare, Waukesha, WI). The PET/CT and IDEAL IQ were registered, and BM subvolumes were segmented above the mean standardized uptake value and below the mean fat fraction within the pelvis and lumbar spine; their intersection was designated as functional BM for IMRT planning. Functional BM-sparing vs total BM-sparing IMRT plans were compared in 12 subjects; 10 were treated with functional BM-sparing pelvic IMRT per protocol.
In gynecologic cancer patients, the mean functional BM V(10) (volume receiving ≥10 Gy) and V(20) (volume receiving ≥20 Gy) were 85% vs 94% (P<.0001) and 70% vs 82% (P<.0001), respectively, for functional BM-sparing IMRT vs total BM-sparing IMRT. In anal cancer patients, the corresponding values were 75% vs 77% (P=.06) and 62% vs 67% (P=.002), respectively. Of 10 subjects treated with functional BM-sparing pelvic IMRT, 3 (30%) had acute grade 3 hematologic toxicity or greater.
IMRT can reduce dose to BM subregions identified by (18)F-fluorodeoxyglucose-PET/CT and IDEAL IQ. The efficacy of BM-sparing IMRT is being tested in a phase II trial.
Metrics
Details
- Title
- Prospective study of functional bone marrow-sparing intensity modulated radiation therapy with concurrent chemotherapy for pelvic malignancies
- Creators
- Yun Liang - University of California San DiegoMark Bydder - University of California San DiegoCatheryn M Yashar - University of California San DiegoBrent S Rose - University of California San DiegoMariel Cornell - University of California San DiegoCarl K Hoh - University of California San DiegoJoshua D Lawson - University of California San DiegoJohn Einck - University of California San DiegoCheryl Saenz - University of California San DiegoPaul Fanta - University of California San DiegoArno J Mundt - University of California San DiegoGraeme M Bydder - University of California San DiegoLoren K Mell - University of California San Diego
- Publication Details
- International journal of radiation oncology, biology, physics, v 85(2), pp 406-414
- Publisher
- Elsevier
- Grant note
- L30-CA135746-01 / NCI NIH HHS T32-RR023254 / NCRR NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000313642000029
- Scopus ID
- 2-s2.0-84872170621
- Other Identifier
- 991021897483804721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging