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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...
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| Published in: | Radiotherapy and oncology 2014-03, Vol.110 (3), p.441-447 |
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| creator | Maraldo, M.V Brodin, N.P Aznar, M.C Vogelius, I.R Munck af Rosenschöld, P Petersen, P.M Specht, L |
| description | 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. |
| doi_str_mv | 10.1016/j.radonc.2013.09.027 |
| format | article |
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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.</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2013.09.027</identifier><identifier>PMID: 24188865</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>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</subject><ispartof>Radiotherapy and oncology, 2014-03, Vol.110 (3), p.441-447</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2013 Elsevier Ireland Ltd</rights><rights>Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-21ca6d64e4e8f8f699aeccec81989a5dd087ac0a2c25d22c5918676679726323</citedby><cites>FETCH-LOGICAL-c417t-21ca6d64e4e8f8f699aeccec81989a5dd087ac0a2c25d22c5918676679726323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24188865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maraldo, M.V</creatorcontrib><creatorcontrib>Brodin, N.P</creatorcontrib><creatorcontrib>Aznar, M.C</creatorcontrib><creatorcontrib>Vogelius, I.R</creatorcontrib><creatorcontrib>Munck af Rosenschöld, P</creatorcontrib><creatorcontrib>Petersen, P.M</creatorcontrib><creatorcontrib>Specht, L</creatorcontrib><title>Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>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.</description><subject>3DCRT</subject><subject>Adult</subject><subject>Female</subject><subject>Head - radiation effects</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hodgkin Disease - pathology</subject><subject>Hodgkin Disease - radiotherapy</subject><subject>Hodgkin lymphoma</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - radiation effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neck - radiation effects</subject><subject>Neoplasm Staging</subject><subject>Normal tissues</subject><subject>Organs at Risk</subject><subject>Proton Therapy</subject><subject>Radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted - adverse effects</subject><subject>Radiotherapy, Conformal - adverse effects</subject><subject>Radiotherapy, Intensity-Modulated - adverse effects</subject><subject>VMAT</subject><issn>0167-8140</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNqFkU1vEzEQhi0EomnLP0DIRy67jL0f9l6QUEtbpEoc6N1y7dnEidcO9ibS_nscpeXAhZMPfueZmWcI-cigZsD6L9s6aRuDqTmwpoahBi7ekBWTYqhASvGWrEpMVJK1cEEuc94CAIdGvCcXvGVSyr5bkfVtzJjpHOkGtaU6WBrQ7GiIadKezi7nQ_kfY6Kok19onvUa6UO0650L1C_TfhMnTfU4Y6IuHKM_YmFEi7TM5-K8waT3yzV5N2qf8cPLe0We7r4_3TxUjz_vf9x8e6xMy8RccWZ0b_sWW5SjHPth0GgMGskGOejOWpBCG9Dc8M5ybrqByV70vRgE7xveXJHPZ-w-xd9l8FlNLhv0XgeMh6xYV0CtZNCUaHuOmhRzTjiqfXKTTotioE6G1VadDauTYQWDKoZL2aeXDofnCe3folelJfD1HMCy5tFhUtk4DAatS2hmZaP7X4d_Aca74Iz2O1wwb-MhhaJQMZW5AvXrdOXTkVkD0PEC-AN_n6QU</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Maraldo, M.V</creator><creator>Brodin, N.P</creator><creator>Aznar, M.C</creator><creator>Vogelius, I.R</creator><creator>Munck af Rosenschöld, P</creator><creator>Petersen, P.M</creator><creator>Specht, L</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140301</creationdate><title>Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy</title><author>Maraldo, M.V ; Brodin, N.P ; Aznar, M.C ; Vogelius, I.R ; Munck af Rosenschöld, P ; Petersen, P.M ; Specht, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-21ca6d64e4e8f8f699aeccec81989a5dd087ac0a2c25d22c5918676679726323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>3DCRT</topic><topic>Adult</topic><topic>Female</topic><topic>Head - radiation effects</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Hodgkin Disease - pathology</topic><topic>Hodgkin Disease - radiotherapy</topic><topic>Hodgkin lymphoma</topic><topic>Humans</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - radiation effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neck - radiation effects</topic><topic>Neoplasm Staging</topic><topic>Normal tissues</topic><topic>Organs at Risk</topic><topic>Proton Therapy</topic><topic>Radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted - adverse effects</topic><topic>Radiotherapy, Conformal - adverse effects</topic><topic>Radiotherapy, Intensity-Modulated - adverse effects</topic><topic>VMAT</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maraldo, M.V</creatorcontrib><creatorcontrib>Brodin, N.P</creatorcontrib><creatorcontrib>Aznar, M.C</creatorcontrib><creatorcontrib>Vogelius, I.R</creatorcontrib><creatorcontrib>Munck af Rosenschöld, P</creatorcontrib><creatorcontrib>Petersen, P.M</creatorcontrib><creatorcontrib>Specht, L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maraldo, M.V</au><au>Brodin, N.P</au><au>Aznar, M.C</au><au>Vogelius, I.R</au><au>Munck af Rosenschöld, P</au><au>Petersen, P.M</au><au>Specht, L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy</atitle><jtitle>Radiotherapy and oncology</jtitle><addtitle>Radiother Oncol</addtitle><date>2014-03-01</date><risdate>2014</risdate><volume>110</volume><issue>3</issue><spage>441</spage><epage>447</epage><pages>441-447</pages><issn>0167-8140</issn><eissn>1879-0887</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>24188865</pmid><doi>10.1016/j.radonc.2013.09.027</doi><tpages>7</tpages></addata></record> |
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| ispartof | Radiotherapy and oncology, 2014-03, Vol.110 (3), p.441-447 |
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| 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 |
| title | Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy |
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