目的 测试盆腔骨髓保留调强放疗 (PBMS-IMRT) 在减少接受盆腔放疗 (RT) 的宫颈癌患者骨密度损失方面的有效性和可行性。 Ib2-IIIc 期非手术宫颈癌患者被随机分组分配到PBMS组或对照组。 PBMS 组另外接受 PBM 剂量限制。在基线以及治疗后 1、3、6、9 和 12 个月时获取计算机断层扫描 (CT) 成像集。登记辐射剂量和亨斯菲尔德单位 (HU)。记录不同随访时间点的骨密度丢失率和骨折事件。对PBMS组90例患者和对照组86例患者的数据进行统计分析，其中包括30例和26例大视野放疗患者（ EFR），分别。所有患者的中位随访时间为 12 个月。与基线相比，PBMS 组和对照组末次随访时所有骨骼的骨密度分别下降了 43% 和 53%，其中治疗后 1 个月下降最显着。尽管未进行大范围放射治疗的患者上腰椎接受的照射量很少，但骨密度却下降了 22.33%。在EFR患者组中，下降了51.18%（P < 0.01）。 PBMS组和对照组患者腰椎或骨盆骨折的发生率分别为7.8%和12.79%。在剂量学参数中，平均剂量与骨密度损失的相关性最强。在接受盆腔放疗的患者中，骨密度损失可能在放疗后早期就开始出现，并且可以发生在照射野内部或外部。本研究结果表明，与单独 IMRT 相比，PBMS-IMRT 减少了骨矿物质密度损失。版权所有 © 2024。由 Elsevier Inc. 出版。

To test the efficacy and feasibility of pelvic bone marrow sparing intensity modulated radiotherapy (PBMS-IMRT) in reducing bone density loss for patients with cervical cancer undergoing pelvic radiotherapy (RT).Non-surgical cervical cancer patients with Stage Ib2-IIIc cancer were randomly allocated into the PBMS group or the control group. The PBMS group additionally received PBM dose constraint. Computed tomography (CT) imaging sets were acquired at baseline and at 1, 3, 6, 9, and 12 months after treatment. Radiation dose and Hounsfield unit (HU) were registered. Bone density loss rates and fracture events at different follow-up time points were recorded.Data from 90 patients in the PBMS group and 86 patients in the control group were used for statistical analysis, which included 30 and 26 patients with extended-field RT (EFR), respectively. The median follow-up for all patients was 12 months. Compared to baseline, the bone density of all bones at the last follow-up had decreased by 43% and 53% in the PBMS and control groups, respectively, with the most significant decline at 1 month after treatment. Although patients without extended-field radiation received minimal irradiation in the upper lumbar spine, a 22.33% decrease in bone density was detected. In the group of patients with EFR, the decrease was 51.18% (P < 0.01). Lumbar or pelvic fracture incidence rates of patients in the PBMS and control groups were 7.8% and 12.79%, respectively. Among the dosimetric parameters, mean dose had the strongest correlation with bone density loss.In patients undergoing pelvic RT, the loss of bone density can begin to appear early after RT, and it can occur either inside or outside of the irradiation field. Results of this study showed that PBMS-IMRT reduced bone mineral density loss compared with IMRT alone.Copyright © 2024. Published by Elsevier Inc.