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Intensity modulated radiotherapy in early stage Hodgkin lymphoma patients: is it better than three dimensional conformal radiotherapy?
De Sanctis, Vitaliana; Bolzan, Chiara; D'Arienzo, Marco; Bracci, Stefano; Fanelli, Alessandro; Cox, Maria Christina; Valeriani, Maurizio; Osti, Mattia F; Minniti, Giuseppe; Chiacchiararelli, Laura; Enrici, Riccardo Maurizi.
Afiliação
  • De Sanctis V; Departments of Radiotherapy, Sant'Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
Radiat Oncol ; 7: 129, 2012 Aug 02.
Article em En | MEDLINE | ID: mdl-22857015
BACKGROUND: Cure rate of early Hodgkin Lymphoma are high and avoidance of late toxicities is of paramount importance. This comparative study aims to assess the normal tissue sparing capability of intensity-modulated radiation therapy (IMRT) versus standard three-dimensional conformal radiotherapy (3D-CRT) in terms of dose-volume parameters and normal tissue complication probability (NTCP) for different organs at risk in supradiaphragmatic Hodgkin Lymphoma (HL) patients. METHODS: Ten HL patients were actually treated with 3D-CRT and all treatments were then re-planned with IMRT. Dose-volume parameters for thyroid, oesophagus, heart, coronary arteries, lung, spinal cord and breast were evaluated. Dose-volume histograms generated by TPS were analyzed to predict the NTCP for the considered organs at risk, according to different endpoints. RESULTS: Regarding dose-volume parameters no statistically significant differences were recorded for heart and origin of coronary arteries. We recorded statistically significant lower V30 with IMRT for oesophagus (6.42 vs 0.33, p = 0.02) and lungs (4.7 vs 0.1 p = 0.014 for the left lung and 2.59 vs 0.1 p = 0.017 for the right lung) and lower V20 for spinal cord (17.8 vs 7.2 p = 0.02). Moreover the maximum dose to the spinal cord was lower with IMRT (30.2 vs 19.9, p <0.001). Higher V10 with IMRT for thyroid (64.8 vs 95, p = 0.0019) and V5 for lungs (30.3 vs 44.8, p = 0.03, for right lung and 28.9 vs 48.1, p = 0.001 for left lung) were found, respectively. Higher V5 and V10 for breasts were found with IMRT (V5: 4.14 vs 20.6, p = 0.018 for left breast and 3.3 vs 17, p = 0.059 for right breast; V10: 2.5 vs 13.6 p = 0.035 for left breast and 1.7 vs 11, p = 0.07 for the right breast.) As for the NTCP, our data point out that IMRT is not always likely to significantly increase the NTCP to OARs. CONCLUSIONS: In HL male patients IMRT seems feasible and accurate while for women HL patients IMRT should be used with caution.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Lesões por Radiação / Planejamento da Radioterapia Assistida por Computador / Doença de Hodgkin / Radioterapia Conformacional / Radioterapia de Intensidade Modulada / Órgãos em Risco Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Radiat Oncol Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Lesões por Radiação / Planejamento da Radioterapia Assistida por Computador / Doença de Hodgkin / Radioterapia Conformacional / Radioterapia de Intensidade Modulada / Órgãos em Risco Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Radiat Oncol Ano de publicação: 2012 Tipo de documento: Article