Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study.
Radiat Oncol
; 9: 58, 2014 Feb 18.
Article
em En
| MEDLINE
| ID: mdl-24548307
ABSTRACT
BACKGROUND:
To estimate the risk of radiation induced second cancers after radiotherapy using deep-inspiration breath-hold (DI) technique with three-dimensional conformal (3DCRT) and volumetric arc therapy (VMAT) for patients with Hodgkin's lymphoma (HL).METHODS:
Early-stage HL with mediastinal and supraclavicular involvement was studied using an Alderson phantom. A whole body CT was performed and all tissues were delineated. The clinical target volumes and planning target volumes (PTV) were determined according to the German Hodgkin study group guidelines. Free-breathing (FB) technique and DI technique were simulated by different safety margins for the PTV definition. In both cases, 30 Gy in 15 fractions was prescribed. Second cancer risk was estimated for various tissues with a second cancer model including fractionation.RESULTS:
When compared with FB-3DCRT, estimated relative life time attributable risk (LAR) of cancer induction after DI-3DCRT was 0.86, 0.76, 0.94 and 0.92 for breast, lung, esophagus and stomach, respectively. With DI-VMAT, the corresponding values were 2.05, 1.29, 1.01, 0.93, respectively. For breast cancer, the LAR observed with DI-VMAT was not substantially distinguishable from the LAR computed for mantle RT with an administered dose of 40 Gy.CONCLUSIONS:
This study suggests that DI may reduce the LAR of secondary cancers of all OARs and may be a valuable technique when using 3DCRT. Conversely, VMAT may increase substantially the LAR and should be cautiously implemented in clinical practice.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Hodgkin
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Irradiação Linfática
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Inalação
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Segunda Neoplasia Primária
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Radioterapia de Intensidade Modulada
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Suspensão da Respiração
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Neoplasias Induzidas por Radiação
Tipo de estudo:
Etiology_studies
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Guideline
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Radiat Oncol
Ano de publicação:
2014
Tipo de documento:
Article