Impact of bone marrow radiation dose on acute hematologic toxicity in cervical cancer: Principal component analysis on high dimensional data

Yun Liang, Karen Messer, Brent S. Rose, John H. Lewis, Steve B. Jiang, Catheryn M. Yashar, Arno J. Mundt, Loren K. Mell

Research output: Contribution to journalArticle

28 Scopus citations


Purpose: To study the effects of increasing pelvic bone marrow (BM) radiation dose on acute hematologic toxicity in patients undergoing chemoradiotherapy, using a novel modeling approach to preserve the local spatial dose information. Methods and Materials: The study included 37 cervical cancer patients treated with concurrent weekly cisplatin and pelvic radiation therapy. The white blood cell count nadir during treatment was used as the indicator for acute hematologic toxicity. Pelvic BM radiation dose distributions were standardized across patients by registering the pelvic BM volumes to a common template, followed by dose remapping using deformable image registration, resulting in a dose array. Principal component (PC) analysis was applied to the dose array, and the significant eigenvectors were identified by linear regression on the PCs. The coefficients for PC regression and significant eigenvectors were represented in three dimensions to identify critical BM subregions where dose accumulation is associated with hematologic toxicity. Results: We identified five PCs associated with acute hematologic toxicity. PC analysis regression modeling explained a high proportion of the variation in acute hematologicity (adjusted R2, 0.49). Three-dimensional rendering of a linear combination of the significant eigenvectors revealed patterns consistent with anatomical distributions of hematopoietically active BM. Conclusions: We have developed a novel approach that preserves spatial dose information to model effects of radiation dose on toxicity, which may be useful in optimizing radiation techniques to avoid critical subregions of normal tissues. Further validation of this approach in a large cohort is ongoing.

Original languageEnglish (US)
Pages (from-to)912-919
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number3
StatePublished - 2010



  • Cervical cancer
  • Chemoradiotherapy
  • Deformable image registration
  • Hematologic toxicity
  • Principal component analysis

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research
  • Medicine(all)

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