Radiation Oncology/Toxicity/Bone marrow

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See also: Radiation Oncology/IMRT/Pelvis


Bone marrow distribution[edit]


Distribution of Bone Marrow

  • 1961: (London) - PMID 13726497 — "The distribution of active bone marrow in the adult." Ellis RE et al. Phys Med Biol. 1961 Jan;5:255-8.
    • By weighing cadaveric bones.
Site % Total red marrow
Pelvis
(made up of)
40.0
Pelvic bones
22.3
Sacrum
13.9
Femoral head/neck
3.8
Thoracic spine 14.1
Lumbar spine 10.9
Head 13.1
Upper Limb Girdle
(made up of)
8.3
Scapulae
4.8
Humeri
1.9
Clavicles
1.5
Ribs 7.9
Cervical spine 3.4
Sternum 2.3


Cervical Cancer[edit]

  • UC San Diego
    • 2011 PMID 20400238 -- "Normal tissue complication probability modeling of acute hematologic toxicity in cervical cancer patients treated with chemoradiotherapy." (Rose BS, Int J Radiat Oncol Biol Phys. 2011 Mar 1;79(3):800-7. Epub 2010 Apr 17.)
      • Retrospective. 81 patients treated with concurrent chemo-RT for cervical cancer. DVHs of bone marrow in pelvic field evaluated
      • Outcome: V10 <95% and V20 <76% correlated with lower acute G3+ hematologic toxicity. V10 (25% vs 69%, SS) and V20 (22% vs 58%, SS)
      • Conclusion: Acute hematologic toxicity increases with increasing pelvic bone marrow volume irradiated