The Pulmonary Effect of Mantle Irradiation in Patients with Hodgkin's Disease

Lokich, Jacob J.; Bass, Harry; Eberly, Frederick E.; Rosenthal, David S.; Moloney, William C.

doi:10.1148/108.2.397

Cited by 38 publications

(11 citation statements)

References 5 publications

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“…This impairment was represented by a 10 per cent reduction in TLC and VC, with a small increase in RV/TLC, and by a decrease of 10 and 20 per cent, respectively, in FEVl and MVV. The balanced reduction in VC and FEVl demonstrates a restrictive damage; the interstitial edema occurring during the acute pneumonitis, as suggested by others (11,17), was the most probable cause of this type of damage. The contemporary impairment of TLCO (mean decrease 17 % at 3 to 6 months) and of DeltaA-a02 (mean increase 4.5 mmHg) indicates that an unbalance between ventilation and perfusion also occurred.…”

Section: Discussionsupporting

confidence: 54%

“…(17) monitored serially 11 patients treated on a mantle volume, with pulmonary function tests at 3-month intervals after irradiation up to 21 months; a different pattern was observed for 6 patients with and for 5 patients without initial mediastinal involvement. Patients without mediastinal adenopathies showed a reduction in TLC and in inspiratory capacity up to 9 months after irradiation.…”

Section: Discussionmentioning

confidence: 99%

“…On exertion, however, many of the patients report a more or less marked decrease in their capacity, usually considered as due to impairment of respiratory function. The functional effects of pulmonary damage by mantle irradiation do not, however, seem to be completely clear, and only a small num-ber of pulmonary function studies have in fact been published (3,8,11,13,14,17,22,24,25). In many of these investigations the pre-treatment values (PTV) of the evaluated functional parameters were not reported; furthermore, results are difficult to compare, as different methods and different criteria of evaluation were used.…”

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Respiratory Function Tests after Mantle Irradiation in Patients with Hodgkin's Disease

Cionini¹,

Pacini²,

Paola³

et al. 1984

Acta Radiologica: Oncology

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Respiratory Function Tests after Mantle Irradiation in Patients with Hodgkin's Disease

Cionini¹,

Pacini²,

Paola³

et al. 1984

Acta Radiologica: Oncology

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“…They disagree as to whether these modifications lessen over 1 to 2 years following the treatment (Lokich et al, 1973).…”

Section: Discussionmentioning

confidence: 99%

“…The literature contains a number of reports on both cardiac and pulmonary complications, often severe, following mantle field irradiation, but many of these reports concern treatment techniques now considered as out of date (Applefeld et al, 1982;Do Pico et al, 1979;Gottdiener et al, 1983;Host & Yale, 1973;Larson et al, 1976;Lokich et al, 1973). More recent data suggest a dramatic decrease in these sequelae over the past decade as a result of refined treatment techniques (Carmel & Kaplan, 1976;Morgan et al, 1985;Smith et al, 1989).…”

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Late cardiopulmonary toxicity after treatment for Hodgkin's disease

Allavena

Conroy²,

Aletti³

et al. 1992

Br J Cancer

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Summary Cardiac and pulmonary functions were evaluted in 75 patients aged 50 years or under, treated for Hodgkin's disease by mantle radiotherapy at least 3 years earlier; all received the same mantle field radiotherapy: radiotherapy alone, MOPP chemotherapy plus radiotherapy, MOPP and ABVD chemotherapy plus radiotherapy.No patient had any symptom of heart disease. Only borderline abnormalities of ECG or echocardiogram were observed in 12 patients. One of them showed a moderate aortic stenosis which was known before the treatment; apical or septum hypokinesia were present in four patients and one patient had a slightly right ventricular dilatation.Twelve (16%) chest radiographs showed moderate or severe abnormalities, but there was no significant correlation between the results of pulmonary function tests and Xenon ventilation/perfusion scintigraphy, the clinical examination and the intensity of the radiological sequelae. Twenty-nine (64%) Xenon scintigraphies showed a reduction of lung perfusion in the irradiated areas without any symptom. The resting mean pulmonary function test was significantly lower for the patients than for the control group with regard to Total Capacity and Vital Capacity. The exercise tolerance, as indicated by analysis of blood gases, was below the one expected for only two patients who were dyspneic during the low level of exercise. We did not find any significant difference between the three treatment groups.We conclude that the treatment with mantle field under good technical conditions (high energy photons, moderate doses ...) can result in minimal cardiopulmonary dysfunction.

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The lymphomas: Response to irradiation

Fayos

Edlund

Knapp

et al. 1974

Cancer

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Four hundred eighty‐four patients with lymphoma received initial irradiation at the University of Michigan from the years 1960 through 1971. No patient with staging celiotomy was included. The distribution was as follows: Hodgkin's disease, 46.9%; lymphosarcoma, 26.7%; reticulum cell sarcoma, 23.5%; and unclassified lymphoma, 2.9%. In most instances, only involved regions were irradiated in the non‐Hodgkin's lymphomas. Hodgkin's disease was treated regionally, but in supradiaphragmatic disease, adjacent areas received prophylactic irradiation, in recent years with the use of a mantle. Present doses vary between 3500–4500 rad given in 4 to 5 weeks. Complications were minimal. The reactivation‐free interval at 6 years for Stages I and II nodal was 41%, 32%, and 31% for Hodgkin's, lymphosarcoma, and reticulum cell sarcoma. A non‐nodal component on first reactivation was found in 24% of Hodgkin's, 33% of lymphosarcoma, and 41% of reticulum cell sarcoma. In these two groups, systematic total nodal irradiation probably would have had no potential benefit. The authors conclude that limited irradiation in early stages (after staging celiotomy) has merits.

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The Pulmonary Effect of Mantle Irradiation in Patients with Hodgkin's Disease

Cited by 38 publications

References 5 publications

Respiratory Function Tests after Mantle Irradiation in Patients with Hodgkin's Disease

Respiratory Function Tests after Mantle Irradiation in Patients with Hodgkin's Disease

Late cardiopulmonary toxicity after treatment for Hodgkin's disease

The lymphomas: Response to irradiation

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