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Stereotactic Radiosurgery for Gynecologic Cancer

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Published on: April 17, 2012

Correlation Between Dosimetric Parameters and Hematologic Toxicity in Cervical Cancer Patients Undergoing

Shuang Zhao¹, Xi Yang¹, Lu Zhang¹

¹Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

|March 28, 2026

Summary

Artificial intelligence aids in delineating pelvic bone marrow for cervical cancer patients undergoing radiotherapy. Chemotherapy, particularly combined neoadjuvant and concurrent, emerged as a stronger predictor of hematologic toxicity than radiation dose parameters.

Keywords:

cervical cancer chemoradiotherapy dosimetric parameters hematologic toxicity pelvic bone marrow

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Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

Published on: March 11, 2021

Area of Science:

Oncology
Medical Physics
Radiotherapy

Background:

Hematologic toxicity (HT) is a significant concern in cervical cancer (CC) radiotherapy (RT).
Accurate delineation of pelvic bone marrow (PBM) is crucial for assessing radiation dose and predicting HT.
Artificial intelligence (AI) offers potential for automated organ at risk (OAR) delineation.

Purpose of the Study:

To investigate the association between PBM dosimetric parameters and HT in CC patients treated with RT.
To evaluate the utility of AI-assisted OAR delineation in this context.
To identify predictors of HT in CC patients receiving RT and chemotherapy.

Main Methods:

Retrospective analysis of 141 CC patients treated with pelvic volumetric modulated arc therapy (VMAT).
AI-based segmentation used for PBM and subregion delineation (ilium, lower pelvis, lumbosacral spine, femoral heads).
Logistic regression models assessed associations between dosimetric parameters (V10-V40) and HT (grades ≥2 and ≥3).

Main Results:

75.8% of patients developed grade ≥2 HT (HT2+), and 23.4% developed grade ≥3 HT (HT3+).
Chemotherapy and age were associated with HT2+ in univariate analysis.
Femoral head V30, femoral head V40, and chemotherapy were independent predictors of HT3+.

Conclusions:

AI-based OAR delineation shows promise for assessing PBM dosimetry in CC patients.
Minimizing PBM radiation dose may reduce HT and improve treatment tolerance.
Combined neoadjuvant and concurrent chemotherapy (NACT+CCRT) was a stronger HT predictor than most BM dosimetric parameters, indicating chemotherapy's dominant systemic effect.