Are there any known bone marrow constraints that should be utilized for prostate IMRT?

Are they necessary? Any group of patients that you use them on (concurrent ADT, anemia, or use of whole pelvis, etc)?

1 Answer

Mednet MemberInvited Expert

Radiation Oncology · UC San Diego

Answered on

We do not contour the bones/marrow for standard prostate patients here, nor have I seen this specified in prostate RT trial protocols.

Extrapolating from gyn trials would be reasonable, but I tend to think of those marrow constraints as more important for patients getting cytotoxic chemotherapy, which is unusual in definitive prostate cancer treatment.

For reference, those would be:

RTOG 1203 TIME-C protocol: V40Gy≤37%, V10Gy≤90%. (Klopp et al., PMID 29989857)

INTERTECC protocol: mean ≤15 Gy (≤25 acceptable), V10Gy≤80% (≤90%), V20Gy≤66% (≤75%).