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Purpose: Hodgkin lymphoma (HL) is one of the most frequent malignancies among pediatric patients. One of the common causes of death in HL survivors after radiation therapy (RT), is radiation-induced heart disease (RIHD). The aim of this study was to compare several dosimetric parameters for two methods of early stage Hodgkin lymphoma radiotherapy with reference to potential risk of RIHD. Materials and Methods: Using a series of computed tomography slices of 40 young patients, treatment planning was done in two methods of HL RT, including involved field (IFRT) and involved site (ISRT) in doses of 20, 30, and 35 Gy. Contouring of clinical target volume as well as the organs at risk, including the heart, was performed by a radiation oncologist. The mean and maximum dose of heart (Dheart-mean and Dheart-max), the volume of heart receiving a dose more than 25 Gy (V25), and the standard deviation of dose as a dose homogeneity index in heart, were used to compare the RIHD risk. Results: The mean value for Dheart-mean in ISRT method in all doses was less compare to IFRT. Maximum reduction in mean value of Dheart-mean occurred at moving from 30 Gy IFRT to ISRT by 9.53 Gy (p < 0.001) and minimum was between 35 Gy IFRT and ISRT. The mean value for Dheart-max was fewer in IFRT rather than ISRT and the maximum difference was between 35 Gy IFRT and ISRT (1.35 Gy). The mean of V25 of heart was 26.66% and 23.74% in 35 Gy IFRT and ISRT, respectively, and dose distribution was more homogeneous in IFRT. Conclusions: If Dheart-max and V25 of heart or homogeneity of dose distribution in heart are considered as determining factors in RIHD, then IFRT can be considered optimum, especially in 35 Gy IFRT; while, assuming the Dheart-mean as the most important factor in RIHD, superiority of ISRT over IFRT is observed.
Słowa kluczowe
Rocznik
Tom
Strony
121--126
Opis fizyczny
Bibliogr. 27 poz., rys., tab.
Twórcy
autor
- Medical Physics Dept, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
autor
- Department of Radiation Oncology, Sadra RT Center, Qom, Iran
autor
autor
- Medical Physics Dept, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Bibliografia
- [1] Halperin EC, Brady LW, Perez CA, et al. Perez & Brady’s Principles and Practice of Radiation Oncology. Wolters Kluwer Health; 2013.
- [2] Donaldson SS, Hudson MM, Lamborn KR, et al. VAMP and low-dose, involved-field radiation for children and adolescents with favorable, early-stage Hodgkin’s disease: results of a prospective clinical trial. J Clin Oncol. 2002;20(14):3081-3087.
- [3] Specht L, Yahalom J, Illidge T, et al. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG). Int J Radiat Oncol Biol Phys. 2014;89(4):854-862.
- [4] Aleman BM, van den Belt-Dusebout AW, Klokman WJ, et al. Long-term cause-specific mortality of patients treated for Hodgkin’s disease. J Clin Oncol. 2003;21(18):3431-3439.
- [5] Ng AK. Review of the cardiac long-term effects of therapy for Hodgkin lymphoma. Br J Haematol. 2011;154(1):23-31.
- [6] Baker JE, Moulder JE, Hopewell JW. Radiation as a risk factor for cardiovascular disease. Antioxid Redox Signalg. 2011;15(7):1945-1956.
- [7] Emami B. Tolerance of normal tissue to therapeutic radiation. Rep Rradiother Oncol. 2013;1(1):123-127.
- [8] Gagliardi G, Constine LS, Moiseenko V, et al. Radiation dose-volume effects in the heart. Int J Radiat Oncol Biol Phys. 2010;76(3):S77-S85.
- [9] Hahn E, Jiang H, Ng A, et al. Late Cardiac Toxicity After Mediastinal Radiation Therapy for Hodgkin Lymphoma: Contributions of Coronary Artery and Whole Heart Dose-Volume Variables to Risk Prediction. Int J Radiat Oncol Biol Phys. 2017;98(5):1116-1123.
- [10] Jakacki RI, Goldwein JW, Larsen RL, et al. Cardiac dysfunction following spinal irradiation during childhood. J Clin Oncol. 1993;11(6):1033-1038.
- [11] Tukenova M, Guibout C, Oberlin O, et al. Role of cancer treatment in long-term overall and cardiovascular mortality after childhood cancer. J Clin Oncol. 2010;28(8):1308-1315.
- [12] Hoppe R. Hodgkin’s disease: complications of therapy and excess mortality. Ann Oncol. 1997;8(suppl 1):S115-S118.
- [13] Ng AK, Bernardo MP, Weller E, et al. Long-term survival and competing causes of death in patients with early-stage Hodgkin’s disease treated at age 50 or younger. J Clin Oncol. 2002;20(8):2101-2108.
- [14] Swerdlow AJ, Higgins CD, Smith P, et al. Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study. J Natl Cancer Inst. 2007;99(3):206-214.
- [15] Paumier A, Ghalibafian M, Beaudre A, et al. Involved-node radiotherapy and modern radiation treatment techniques in patients with Hodgkin lymphoma. Int J Radiat Oncol Biol Phys. 2011;80(1):199-205.
- [16] Engert A, Pluetschow A, Eich HT, et al. Combined Modality Treatment of Two or Four Cycles of ABVD Followed by Involved Field Radiotherapy in the Treatment of Patients with Early Stage Hodgkin’s Lymphoma: Update Interim Analysis of the Randomised HD10 Study of the German Hodgkin Study Group (GHSG). Blood. 2005;106(11):2673.
- [17] Yahalom J, Mauch P. The involved field is back: issues in delineating the radiation field in Hodgkin’s disease. Ann Oncol. 2002;13(suppl 1):79-83.
- [18] Hoskin P, Díez P, Williams M, et al. Recommendations for the use of radiotherapy in nodal lymphoma. Clin Oncol. 2013;25(1):49-58.
- [19] Herst J, Crump M, Baldassarre F, et al. Management of Early-stage Hodgkin Lymphoma: A Practice Guideline. Clin Oncol. 2017;29(1):e5-e12.
- [20] Campbell BA, Voss N, Pickles T, et al. Involved-nodal radiation therapy as a component of combination therapy for limited-stage Hodgkin’s lymphoma: a question of field size. J Clin Oncol. 2008;26(32):5170-5174.
- [21] Koh E-S, Tran TH, Heydarian M, et al. A comparison of mantle versus involved-field radiotherapy for Hodgkin’s lymphoma: reduction in normal tissue dose and second cancer risk. Radiat Oncol. 2007;2:13.
- [22] Koeck J, Abo-Madyan Y, Lohr F, et al. Radiotherapy for early mediastinal Hodgkin lymphoma according to the German Hodgkin Study Group (GHSG): the roles of intensity-modulated radiotherapy and involved-node radiotherapy. Int J Radiat Oncol Biol Phys. 2012;83(1):268-276.
- [23] Sobin LH, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours. Wiley; 2011.
- [24] Khan FM, Gibbons JP. Khan’s The Physics of Radiation Therapy. Wolters Kluwer Health; 2014.
- [25] Barrett A, Dobbs J, Roques T. Practical Radiotherapy Planning Fourth Edition. Taylor & Francis; 2009.
- [26] Carr ZA, Land CE, Kleinerman RA, et al. Coronary heart disease after radiotherapy for peptic ulcer disease. Int J Radiat Oncol Biol Phys. 2005;61(3):842-850.
- [27] van Nimwegen FA, Schaapveld M, Cutter DJ, et al. Radiation dose-response relationship for risk of coronary heart disease in survivors of Hodgkin lymphoma. J Clin Oncol. 2015;34(3):235-243.
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Bibliografia
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