52 / 1544
Dose-volume constraints for IMRT:
bone marrow
40% of total body bone marrow reserves located in pelvis:
up to 8% hematological toxicity with preop chemoRT
Mell et al (chemoRT anal cancer):
V10-20 significantly correlated with hematological toxicty
= low-dose treshold > myelosuppressive chemotherapy
Dosimetric benefit of IMRT (Mell et al, cervical cancer):
Reduction of lumbosacral BM irradiation all dose levels
Reduction of pelvic BM irradiation to high doses
Yang et al (rectal cancer):
Sacral BM: V45 < 51%
Coxal BM: V45 < 13%
Higher dose treshold (vs anal cancer)
15