Dosimetric Analysis of Limiting Pelvic Bone Dose in Intensity-modulated Radiotherapy for Cervical Cancer

Numerous studies have indicated the significant importance of pelvic dose in the radiotherapy process for cervical cancer patients. However, research on the actual pelvic bone dose in the treatment of cervical cancer patients using different techniques is currently relatively limited. In this study, we selected 50 postoperative cervical cancer patients. For each patient, three treatment plans with pelvic dose constraints were designed: sIMRT, VMAT, and HT. Statistical analysis was conducted on the target area and organ at risk parameters of the three groups of plans. The results indicate that all three treatment plans meet the clinical requirements. Regarding organs at risk, compared to the sIMRT and VMAT groups, the HT group showed a reduction of 11.85% and 11.07%, respectively, in V40 of bladder. Additionally, compared to the sIMRT and HT groups, the VMAT group exhibited a reduction of 14.94% and 9.53%, respectively, in V10 of pelvic bone. Furthermore, compared to the sIMRT and HT groups, the VMAT group showed a reduction of 10.76% and 6.75%, respectively, in V20 of pelvic bone, and these differences were also statistically significant (t = 21.630, t = –16.621, P < 0.05). In summary, individualized treatment design can be conducted in clinical practice based on the specific conditions of patients.