Estimated risk of cardiovascular disease and secondary cancers with modern highly conformal radiotherapy for early-stage mediastinal Hodgkin lymphoma
Maraldo, M. V. ; Brodin, N. P. ; Aznar, M. C. ; Vogelius, I. R. ; Munck af Rosenschöld, P. LU
; Petersen, P. M.
and Specht, L.
(2013)
In Annals of Oncology
24(8).
p.2113-2118
- Abstract
Hodgkin lymphoma (HL) survivors have an increased morbidity and mortality from secondary cancers and cardiovascular disease (CD). We evaluate doses with involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), or proton therapy (PT), compared with the extensive Mantle Field (MF). Patients and methods: For 27 patients with early-stage, mediastinal HL, treated with chemotherapy and INRT delivered as 3D CRT (30 Gy), we simulated an MF (36 Gy), INRT-VMAT and INRT-PT (30 Gy). Dose to the heart, lungs, and breasts, estimated risks of CD, lung (LC) and breast cancer (BC), and corresponding life years lost (LYL) were compared. Results: 3D CRT, VMAT or PT significantly lower the... (More)
Hodgkin lymphoma (HL) survivors have an increased morbidity and mortality from secondary cancers and cardiovascular disease (CD). We evaluate doses with involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), or proton therapy (PT), compared with the extensive Mantle Field (MF). Patients and methods: For 27 patients with early-stage, mediastinal HL, treated with chemotherapy and INRT delivered as 3D CRT (30 Gy), we simulated an MF (36 Gy), INRT-VMAT and INRT-PT (30 Gy). Dose to the heart, lungs, and breasts, estimated risks of CD, lung (LC) and breast cancer (BC), and corresponding life years lost (LYL) were compared. Results: 3D CRT, VMAT or PT significantly lower the dose to the heart, lungs and breasts and provide lower risk estimates compared with MF, but with substantial patient variability. The risk of CD is not significantly different for 3D CRT versus VMAT. The risk of LC and BC is highest with VMAT. For LYL, PT is the superior modern technique. Conclusions: In early-stage, mediastinal HL modern radiotherapy provides superior results compared with MF. However, there is no single best radiotherapy technique for HL-the decision should be made at the individual patient level.
(Less)
- author
- Maraldo, M. V.
; Brodin, N. P.
; Aznar, M. C.
; Vogelius, I. R.
; Munck af Rosenschöld, P.
LU
; Petersen, P. M.
and Specht, L.
- publishing date
- 2013-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiovascular disease, Highly conformal radiotherapy, Hodgkin lymphoma, Involved node radiotherapy, Secondary cancers
- in
- Annals of Oncology
- volume
- 24
- issue
- 8
- pages
- 2113 - 2118
- publisher
- Oxford University Press
- external identifiers
-
- pmid:23619032
- scopus:84881239116
- ISSN
- 0923-7534
- DOI
- 10.1093/annonc/mdt156
- language
- English
- LU publication?
- no
- additional info
- Funding Information: This work was supported by the Rigshospitalet Scientific Committee.
- id
- dfa2a612-2fde-467c-9a16-cc443e60127b
- date added to LUP
- 2023-07-19 17:04:20
- date last changed
- 2024-04-20 00:47:07
@article{dfa2a612-2fde-467c-9a16-cc443e60127b,
abstract = {{<p>Hodgkin lymphoma (HL) survivors have an increased morbidity and mortality from secondary cancers and cardiovascular disease (CD). We evaluate doses with involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), or proton therapy (PT), compared with the extensive Mantle Field (MF). Patients and methods: For 27 patients with early-stage, mediastinal HL, treated with chemotherapy and INRT delivered as 3D CRT (30 Gy), we simulated an MF (36 Gy), INRT-VMAT and INRT-PT (30 Gy). Dose to the heart, lungs, and breasts, estimated risks of CD, lung (LC) and breast cancer (BC), and corresponding life years lost (LYL) were compared. Results: 3D CRT, VMAT or PT significantly lower the dose to the heart, lungs and breasts and provide lower risk estimates compared with MF, but with substantial patient variability. The risk of CD is not significantly different for 3D CRT versus VMAT. The risk of LC and BC is highest with VMAT. For LYL, PT is the superior modern technique. Conclusions: In early-stage, mediastinal HL modern radiotherapy provides superior results compared with MF. However, there is no single best radiotherapy technique for HL-the decision should be made at the individual patient level.</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 = {{0923-7534}},
keywords = {{Cardiovascular disease; Highly conformal radiotherapy; Hodgkin lymphoma; Involved node radiotherapy; Secondary cancers}},
language = {{eng}},
number = {{8}},
pages = {{2113--2118}},
publisher = {{Oxford University Press}},
series = {{Annals of Oncology}},
title = {{Estimated risk of cardiovascular disease and secondary cancers with modern highly conformal radiotherapy for early-stage mediastinal Hodgkin lymphoma}},
url = {{http://dx.doi.org/10.1093/annonc/mdt156}},
doi = {{10.1093/annonc/mdt156}},
volume = {{24}},
year = {{2013}},
}