Aim: Study was to evaluate feasibility and benefits of Bone Marrow Sparing IMRT over Standard IMRT. 

Materials and Methods: Cervical cancer patients undergoing Concurrent Chemo Radiation and brachytherapy and evaluated for haematological, gastrointestinal and genitourinary toxicity at weekly intervals were included in study. Results: Dose constraints to bone marrow of V10<90% and V20<75% were achieved in all patients. Significant reduction in bone marrow V10 and V20 is possible using bone marrow sparing as compared to standard IMRT (V10 87.15% vs. 93.7% and V20 73.55% vs. 83.15%). Bone marrow sparing can be achieved without compromise to target coverage and without increased dose to OAR’s which include bowel, rectum and bladder. Bone marrow sparing appears to show significant reduction in haematological toxicity in terms of fall in haemoglobin, haemoglobin nadir and grade 2 and worse anaemia. Bone marrow sparing appears to show a trend towards reduced haematological toxicity in terms of fall in WBC count, leukocyte nadir and grade 2 and worse leukopenia. 

Conclusions: SPECT­BM imaging may be added to the ever growing list of functional imaging techniques that may play a role in IMRT planning. Bone marrow sparing approach may also benefit patient s with anal and rectal cancers. 

Keywords: Intensity Modulated Radiation,Therapy (IMRT); Single­Photon Emission Computed, Tomography (SPECT) bone Marrow (BM) Imaging; Cervical Cancer