Abstract: Platinum-based concurrent chemoradiotherapy (CCRT) is the standard treatment regimen for locally advanced cervical cancer (LACC). However, this regimen often induces myelosuppression, manifesting as hematological toxicities such as leukopenia, neutropenia, anemia, and thrombocytopenia. Severe myelosuppression can lead to treatment delays or even interruptions, thereby compromising therapeutic efficacy and adversely affecting prognosis. Physical bone marrow sparing radiotherapy, achieved through precise target delineation, physical technique optimization and dose-volume constraints, can mitigate hematological toxicity without compromising tumor control. To date, no unified standards exist regarding specific dose-volume limits and target delineation ranges for physical bone marrow sparing during CCRT for LACC. This article reviews research progress concerning the radiobiological characteristics of bone marrow, physical sparing strategies, and dose-volume parameters, aiming to provide a reference for personalized physical bone marrow protection during CCRT for LACC.
Keywords: cervical cancer; intensity modulated radiation therapy; bone marrow sparing; concurrent chemoradiotherapy; dose distribution optimization
（Acta Laser Biology Sinica, 2026, 35(3): 205-213）