Radiation Oncology/Toxicity/Bone marrow

Also please see Toxicity/Pelvis See also: Radiation Oncology/IMRT/Pelvis Bone marrow distribution 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 marrowPelvis (made up of) 40.0 Pelvic bones 22.3 Sacrum 13.9 Femoral head/neck 3.8Thoracic spine 14.1Lumbar spine 10.9Head 13.1Upper Limb Girdle (made up of) 8.3 Scapulae 4.8 Humeri 1.9 Clavicles 1.5Ribs 7.9Cervical spine 3.4Sternum 2.3 Cervical Cancer 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