WE‐E‐BRD‐01: Investigating Effects of Pelvic Bone Marrow Radiation Dose On Acute Hematologic Toxicity Using High Dimensional Data Analysis

Published on Jun 1, 2009in Medical Physics3.317
· DOI :10.1118/1.3182553
Y. Liang8
Estimated H-index: 8
(UCSD: University of California, San Diego),
Brent S. Rose19
Estimated H-index: 19
(UCSD: University of California, San Diego)
+ 3 AuthorsLoren K. Mell52
Estimated H-index: 52
(UCSD: University of California, San Diego)
Purpose: To develop a new method to investigate the effect of local pelvic bone marrow (BM) radiationdose on acute hematologic toxicity (HT) in cervical cancer patients undergoing concurrent chemoradiation therapy (CRT), with the ultimate goal of optimizing BM‐sparing radiation techniques. Method and Materials: We analyzed 24 cervical cancer patients treated with concurrent cisplatin (40mg/m2/week) and pelvic IMRT. The white blood cell count (WBC) nadir, defined as the lowest value occurring between the start of CRT and two weeks following IMRT, was used as the indicator of acute HT. The pelvic bone region included the os coxae, lower lumbar vertebrae, sacrum, acetabulae, and proximal femora. BM doses were standardized in two steps: pelvic bone registration followed by dose remapping. Simulation CTimages were registered to a common (canonical) template using the optical flow based deformable image registration developed by Yang et al.[2]. The deformation field was used to remap the dose distribution back to the deformed pelvic bones. We generated a data structure called a “dose‐array” that reserves the spatial information of each dose value. The position of an element inside array can be used to trace its location in 3D. Results: Substantial variation of BM dose distribution among the 24 patients was observed. Patients were classified based on their WBC nadir value (⩾ vs. < 2000/μL) into two groups (n=15 vs. n=9, respectively), and the average pelvic BM 3‐D dose distribution was compared visually. Results suggested that patients receiving higher doses to the lower lumbar spine, upper sacrum, and medial ilium, were more likely to develop acute HT. Conclusion: We have developed a novel method to study the impact of BM radiationdose on acute HT. Our next step is to implement both unsupervised and supervised classification models to analyzeradiation effects, for use in IMRT plan optimization.
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#1Brent S. Rose (UCSD: University of California, San Diego)H-Index: 19
#2Bulent Aydogan (U of C: University of Chicago)H-Index: 21
Last. Loren K. Mell (UCSD: University of California, San Diego)H-Index: 52
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Purpose To test the hypothesis that increased pelvic bone marrow (BM) irradiation is associated with increased hematologic toxicity (HT) in cervical cancer patients undergoing chemoradiotherapy and to develop a normal tissue complication probability (NTCP) model for HT. Methods and Materials We tested associations between hematologic nadirs during chemoradiotherapy and the volume of BM receiving ≥10 and 20 Gy (V 10 and V 20 ) using a previously developed linear regression model. The validation c...
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