BACKGROUND: Long-term Hodgkin lymphoma (HL) survivors have an increased risk of late cardiac morbidity and secondary lung cancer after chemotherapy and mediastinal radiotherapy. In this prospective study we investigate whether radiotherapy with deep inspiration breath-hold (DIBH) can reduce radiation doses to the lungs, heart, and cardiac structures without compromising the target dose. PATIENTS AND METHODS: Twenty-two patients (14 female, 8 male), median age 30 years (18-65 years), with supra-diaphragmatic HL were enrolled and had a thoracic PET/CT with DIBH in addition to staging FDG-PET/CT in free breathing (FB) and a planning CT in both FB and DIBH. For each patient an involved-node radiotherapy plan was done for both DIBH and FB, and the doses to the lungs, heart, and female breasts were recorded prospectively. Mean doses to the heart valves and coronary arteries were recorded retrospectively. Patients were treated with the technique yielding the lowest doses to normal structures. RESULTS: Nineteen patients were treated with DIBH and three with FB. DIBH reduced the mean estimated lung dose by 2.0 Gy (median: 8.5 Gy vs. 7.2 Gy) (p < 0.01) and the mean heart dose by 1.4 Gy (6.0 Gy vs. 3.9 Gy) (p < 0.01) compared to FB. The lung and heart V20Gy were reduced with a median of 5.3% and 6.3%. Mean doses to the female breasts were equal with FB and DIBH. CONCLUSION: DIBH can significantly decrease the estimated mean doses to the heart and lungs without lowering the dose to the target in radiotherapy for patients with mediastinal HL.
BACKGROUND: Long-term Hodgkin lymphoma (HL) survivors have an increased risk of late cardiac morbidity and secondary lung cancer after chemotherapy and mediastinal radiotherapy. In this prospective study we investigate whether radiotherapy with deep inspiration breath-hold (DIBH) can reduce radiation doses to the lungs, heart, and cardiac structures without compromising the target dose. PATIENTS AND METHODS: Twenty-two patients (14 female, 8 male), median age 30 years (18-65 years), with supra-diaphragmatic HL were enrolled and had a thoracic PET/CT with DIBH in addition to staging FDG-PET/CT in free breathing (FB) and a planning CT in both FB and DIBH. For each patient an involved-node radiotherapy plan was done for both DIBH and FB, and the doses to the lungs, heart, and female breasts were recorded prospectively. Mean doses to the heart valves and coronary arteries were recorded retrospectively. Patients were treated with the technique yielding the lowest doses to normal structures. RESULTS: Nineteen patients were treated with DIBH and three with FB. DIBH reduced the mean estimated lung dose by 2.0 Gy (median: 8.5 Gy vs. 7.2 Gy) (p < 0.01) and the mean heart dose by 1.4 Gy (6.0 Gy vs. 3.9 Gy) (p < 0.01) compared to FB. The lung and heart V20Gy were reduced with a median of 5.3% and 6.3%. Mean doses to the female breasts were equal with FB and DIBH. CONCLUSION:DIBH can significantly decrease the estimated mean doses to the heart and lungs without lowering the dose to the target in radiotherapy for patients with mediastinal HL.
Authors: Joseph M Connors; Wendy Cozen; Christian Steidl; Antonino Carbone; Richard T Hoppe; Hans-Henning Flechtner; Nancy L Bartlett Journal: Nat Rev Dis Primers Date: 2020-07-23 Impact factor: 52.329
Authors: Chelsea C Pinnix; Grace L Smith; Sarah Milgrom; Eleanor M Osborne; Jay P Reddy; Mani Akhtari; Valerie Reed; Isidora Arzu; Pamela K Allen; Christine F Wogan; Michele A Fanale; Yasuhiro Oki; Francesco Turturro; Jorge Romaguera; Luis Fayad; Nathan Fowler; Jason Westin; Loretta Nastoupil; Fredrick B Hagemeister; M Alma Rodriguez; Sairah Ahmed; Yago Nieto; Bouthaina Dabaja Journal: Int J Radiat Oncol Biol Phys Date: 2015-05-01 Impact factor: 7.038
Authors: Scott C Lester; Kekoa Taparra; Molly M Petersen; Ryan K Funk; Miran J Blanchard; Phillip M Young; Joerg Herrmann; Ashley E Hunzeker; Heather L Schultz; Cynthia McCollough; Alexandria M Tasson; Shuai Leng; James A Martenson; Amanda J Deisher; Thomas J Whitaker; Eric E Williamson; Nadia N Laack Journal: Pract Radiat Oncol Date: 2019-11-26
Authors: Mirjana Josipovic; Marianne C Aznar; Jakob B Thomsen; Jonas Scherman; Sidsel Ms Damkjaer; Lotte Nygård; Lena Specht; Mette Pøhl; Gitte F Persson Journal: Br J Radiol Date: 2019-09-26 Impact factor: 3.039