Intensity-modulated radiotherapy for lymphoma involving the mediastinum Journal Article


Authors: Goodman, K. A.; Toner, S.; Hunt, M.; Wu, E. J.; Yahalom, J.
Article Title: Intensity-modulated radiotherapy for lymphoma involving the mediastinum
Abstract: Purpose: To determine the feasibility, potential advantage, and indications for intensity-modulated radiotherapy (IMRT) in the treatment of Hodgkin's lymphoma or non-Hodgkin's lymphoma involving excessively large mediastinal disease volumes or requiring repeat RT. Methods and Materials: Sixteen patients with Hodgkin's lymphoma (n = 11) or non-Hodgkin's lymphoma (n = 5) undergoing primary radiotherapy or repeat RT delivered via an IMRT plan were studied. The indications for using an IMRT plan were previous mediastinal RT (n = 5) or extremely large mediastinal treatment volumes (n = 11). For each patient, IMRT, conventional parallel-opposed (AP-PA), and three-dimensional conformal (3D-CRT) plans were designed using 6-MV X-rays to deliver doses ranging from 18 to 45 Gy (median, 36 Gy). The plans were compared with regard to dose-volume parameters. The IMRT/AP-PA and IMRT/3D-CRT ratios were calculated for each parameter. Results: For all patients, the mean lung dose was reduced using IMRT, on average, by 12% compared with AP-PA and 14% compared with 3D-CRT. The planning target volume coverage was also improved using IMRT compared with AP-PA but was not different from the planning target volume coverage obtained with 3D-CRT. Conclusion: In selected patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma involving the mediastinum, IMRT provides improved planning target volume coverage and reduces pulmonary toxicity parameters. It is feasible for RT of large treatment volumes and allows repeat RT of relapsed disease without exceeding cord tolerance. Additional follow-up is necessary to determine whether improvements in dose delivery affect long-term morbidity and disease control. © 2005 Elsevier Inc.
Keywords: adult; clinical article; controlled study; middle aged; cancer localization; intensity modulated radiation therapy; comparative study; radiation dose; treatment indication; radiotherapy; hodgkin disease; radiation dosage; mathematical model; nonhodgkin lymphoma; feasibility study; imrt; feasibility studies; hodgkin's lymphoma; dosimetry; lymphoma, non-hodgkin; three dimensional imaging; lung; radiotherapy, conformal; patient treatment; toxicity; disease control; computer assisted radiotherapy; mediastinal neoplasms; mediastinum lymph node; conformal radiotherapy; intensity-modulated radiotherapy (imrt); radiation depth dose; dose-volume parameters; mediastinal radiotherapy; hodgkin's lymphona; non-hodgkin's lymphona
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 62
Issue: 1
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2005-05-01
Start Page: 198
End Page: 206
Language: English
DOI: 10.1016/j.ijrobp.2004.08.048
PUBMED: 15850922
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 36" - "Export Date: 24 October 2012" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Joachim Yahalom
    386 Yahalom
  2. Karyn A Goodman
    240 Goodman
  3. Sean T Toner
    8 Toner
  4. Margie A Hunt
    224 Hunt
  5. Eijean Wu
    3 Wu