Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy

Abstract Purpose To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), i...

Full description

Saved in:
Bibliographic Details
Published in:Radiotherapy and oncology 2014-03, Vol.110 (3), p.441-447
Main Authors: Maraldo, M.V, Brodin, N.P, Aznar, M.C, Vogelius, I.R, Munck af Rosenschöld, P, Petersen, P.M, Specht, L
Format: Article
Language:English
Subjects:
3DCRT
Adult
Female
Head - radiation effects
Hematology, Oncology and Palliative Medicine
Hodgkin Disease - pathology
Hodgkin Disease - radiotherapy
Hodgkin lymphoma
Humans
Lymph Nodes - pathology
Lymph Nodes - radiation effects
Male
Middle Aged
Neck - radiation effects
Neoplasm Staging
Normal tissues
Organs at Risk
Proton Therapy
Radiotherapy
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - adverse effects
Radiotherapy, Conformal - adverse effects
Radiotherapy, Intensity-Modulated - adverse effects
VMAT
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Purpose To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison to the past mantle field (MF). Materials and methods Data from 37 patients with cervical lymph node involvement were used. All patients originally received chemotherapy followed by 3DCRT–INRT (30.6 Gy). A VMAT–INRT, PT–INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs and repeated measures ANOVA. Results The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p < 0.0001), respectively. Conclusion The use of INRT significantly lowered the estimated radiation dose to the head and neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients, PT offered an additional gain.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2013.09.027