Noncoplanar intensity‐modulated radiation therapy for young female patients with mediastinal lymphoma

Chen, Xinyuan; Jin, Dayong; Wang, Shulian; Li, Minghui; Huang, Peng; Dai, Jianrong

doi:10.1120/jacmp.v13i6.3769

Cited by 13 publications

(5 citation statements)

References 28 publications

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“…(13,14) Dose planning studies have previously suggested that advanced radiotherapy techniques could reduce the dose to the organs at risk (OAR) considered in this work. (15)(16)(17) Brodin et al (18) review models for risks of specific radiation-induced effects in patients with HL, focusing on linear models that rely on mean dose for calculation of risk for cancer induction. Risk estimate comparison studies of IFRT techniques for HL, including volumetric-modulated arc therapy and proton therapy by Maraldo et al, (11,19) also use linear models for calculation of secondary cancer risk.…”

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confidence: 99%

Late radiation toxicity in Hodgkin lymphoma patients: proton therapy's potential

Toltz

Shin

Mitrou

et al. 2015

J Applied Clin Med Phys

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In 2010, all young patients treated for intrathoracic Hodgkin lymphoma (HL) at one of 10 radiotherapy centers in the province of Quebec received 3D conformal photon therapy. These patients may now be at risk for late effects of their treatment, notably secondary malignancies and cardiac toxicity. We hypothesized that more complex radiotherapy, including intensity‐modulated proton therapy (IMPT) and possibly IMRT (in the form of helical tomotherapy (HT)), could benefit these patients. With institutional review board approval at 10 institutions, all treatment plans for patients under the age of 30 treated for HL during a six‐month consecutive period of 2010 were retrieved. Twenty‐six patients were identified, and after excluding patients with extrathoracic radiation or treatment of recurrence, 20 patients were replanned for HT and IMPT. Neutron dose for IMPT plans was estimated from published measurements. The relative seriality model was used to predict excess risk of cardiac mortality. A modified linear quadratic model was used to predict the excess absolute risk for induction of lung cancer and, in female patients, breast cancer. Model parameters were derived from published data. Predicted risk for cardiac mortality was similar among the three treatment techniques (absolute excess risk of cardiac mortality was not reduced for HT or IMPT (p>0.05,p>0.05) as compared to 3D CRT). Predicted risks were increased for HT and reduced for IMPT for secondary lung cancer (p<0.001,p<0.001) and breast cancers (p<0.001,p<0.001) as compared to 3D CRT.PACS numbers: 87.55.dh, 87.55.dk

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confidence: 99%

Late radiation toxicity in Hodgkin lymphoma patients: proton therapy's potential

Toltz

Shin

Mitrou

et al. 2015

J Applied Clin Med Phys

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“…Xinyuan Chen et al published a study in 2012 compares coplanar to non-coplanar intensity-modulated radiation therapy to young female patients with mediastinal lymphoma the mean dose, V5 and V10 for the breast and lungs are significantly lower in non-coplanar IMRT than in coplanar IMRT (P < 0.05), also the mean dose to the heart significantly reduced in non-coplanar compared to coplanar IMRT [22].…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison between Coplanar and Non-Coplanar Fields in Irradiation of Middle and Lower Lobes Lung Tumors

Elzawawy¹,

Alzayat²,

Darwish³

2016

IJMPCERO

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Purpose: To compare between the coplanar and non-coplanar fields regarding planning target volume (PTV) coverage, conformity index and preservation of organs at risk (heart-lungs-esophagus and spinal cord). Materials and Methods: 10 patients presented with stage IIIA or IIIB NSCLC with a tumor located in the middle or lower lobes. Because of this location, the heart is one of the main organs at risk. Two plans, coplanar and non-coplanar 3 dimensional conformal radiotherapy plans are performed for each patient. All treatment plans are created using Xio-Computerized medical system treatment planning system. The prescribed dose is 64 Gy in 32 fractions. Results: For both plans, the maximum dose to the PTV doesn't exceed 110% of the prescribed dose; the 95% isodose (60.8 Gy) covers at least 95% of the PTV volume and the mean conformity index values are also very similar 0.59 vs 0.61 for coplanar and non-coplanar plans respectively without statistically significant difference (P = 0.1711). Regarding organs at risk, large advantage for adding a non-coplanar field in the preservation of the heart is observed. The mean V30 values for noncoplanar plan are 17.3 Gy versus 28.9 Gy for the coplanar plan with statistically significant difference (P = 0.0060). Also, the mean V40 and V50 values for the non coplanar compared to coplanar plan are 12.6 Gy and 7.9 Gy versus 23.1 Gy and 14.9 Gy respectively, and these differences are statistically significant (P = 0.0162) (P = 0.0084). No statistically significant differences are found between coplanar and non-coplanar plans for lungs, esophagus or the spinal cord. Conclusion: Using non-coplanar beams in the irradiation of middle and lower lung tumors significantly reduces the radiation dose to the heart with the same target volume coverage and conformity index.

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“…PTV 1 comprises the CTV, including the GTV (i.e., initial tumor mass and lymph node remnant(s)), with an added margin to account for organ movement and set-up variations. PTV 2 consists of the GTV alone, also with a margin to consider organ movement and set-up variations [ 33 ].…”

Section: Design Of Radiation Fieldsmentioning

confidence: 99%

Radiotherapy for tumors of the mediastinum – state of the art

Kantzou,

Sarris,

Kouloulias

et al. 2023

kitp

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Mediastinal tumors encompass a diverse range of malignancies, originating within or spreading to the mediastinum. The administration of radiotherapy within the anatomical confines of the mediastinum presents unique challenges owing to the close proximity of critical organs, including the heart, lungs, esophagus, and spinal cord. However, recent progress in imaging techniques, treatment modalities, and our understanding of tumor biology has significantly contributed to the development of effective and safe therapeutic strategies for mediastinal diseases. This review article aims to explore the latest innovations in radiotherapy and their practical applications in the management of mediastinal tumors, with a primary focus on lymphomas, thymomas, and thymic carcinomas. By examining these advancements, we seek to provide valuable insights into the current state of the art in radiotherapy for mediastinal malignancies, ultimately fostering improved patient outcomes and clinical decision-making.

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Noncoplanar intensity‐modulated radiation therapy for young female patients with mediastinal lymphoma

Cited by 13 publications

References 28 publications

Late radiation toxicity in Hodgkin lymphoma patients: proton therapy's potential

Late radiation toxicity in Hodgkin lymphoma patients: proton therapy's potential

Dosimetric Comparison between Coplanar and Non-Coplanar Fields in Irradiation of Middle and Lower Lobes Lung Tumors

Radiotherapy for tumors of the mediastinum – state of the art

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