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

Maraldo, M. V. ; Brodin, N. P. ; Aznar, M. C. ; Vogelius, I. R. ; Munck Af Rosenschöld, P. LU orcid ; Petersen, P. M. and Specht, L. (2014) In Radiotherapy and Oncology 110(3). p.441-447
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... (More)

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.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
3DCRT, Hodgkin lymphoma, Normal tissues, Proton therapy, Radiotherapy, VMAT
in
Radiotherapy and Oncology
volume
110
issue
3
pages
441 - 447
publisher
Elsevier
external identifiers
  • pmid:24188865
  • scopus:84899528143
ISSN
0167-8140
DOI
10.1016/j.radonc.2013.09.027
language
English
LU publication?
no
additional info
Funding Information: This work was supported by Rigshospitalet Scientific Research Committee, Copenhagen, Denmark .
id
9d6f7878-8a8e-44ba-9b2b-8d03647cc0e7
date added to LUP
2023-07-19 09:38:08
date last changed
2024-03-22 22:20:32
@article{9d6f7878-8a8e-44ba-9b2b-8d03647cc0e7,
  abstract     = {{<p>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 &lt; 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.</p>}},
  author       = {{Maraldo, M. V. and Brodin, N. P. and Aznar, M. C. and Vogelius, I. R. and Munck Af Rosenschöld, P. and Petersen, P. M. and Specht, L.}},
  issn         = {{0167-8140}},
  keywords     = {{3DCRT; Hodgkin lymphoma; Normal tissues; Proton therapy; Radiotherapy; VMAT}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{441--447}},
  publisher    = {{Elsevier}},
  series       = {{Radiotherapy and Oncology}},
  title        = {{Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy}},
  url          = {{http://dx.doi.org/10.1016/j.radonc.2013.09.027}},
  doi          = {{10.1016/j.radonc.2013.09.027}},
  volume       = {{110}},
  year         = {{2014}},
}