Contribution of three-dimensional conformal intensity-modulated radiation therapy for women affected by bulky stage II supradiaphragmatic Hodgkin disease

Radiation Oncology

Georges Noel²  Khalil Bourahla¹  Claudine Niederst²  Philippe Meyer²  Shanti Natarajan-Ame³  Delphine Antoni² 

[1] Nuclear Medicine department, Centre de lutte contre le Cancer Paul Strauss, 3, rue de la Porte de l’Hôpital, Strasbourg Cedex, BP 42, 67065, France;Radiotherapy department, Centre de lutte contre le Cancer Paul Strauss, 3, rue de la Porte de l’Hôpital, Strasbourg Cedex, BP 42, 67065, France;Department of Hematology and Oncology, Hôpital Civil, 1 place de l’Hôpital, Strasbourg, 67098, France

关键词: Dose distribution;    IMRT;    Hodgkin’s lymphoma;   

Others  :  1154004
DOI  :  10.1186/1748-717X-8-112

 received in 2012-10-06, accepted in 2013-04-16,  发布年份 2013

【 摘 要 】

Purpose

To analyze the outcome and dose distribution of intensity-modulated radiation therapy (IMRT) by helical tomotherapy in women treated for large supradiaphragmatic Hodgkin’s disease.

Material and methods

A total of 13 patients received adjuvant radiation at a dose of 30 Gy to the initially involved sites with a boost of 6 Gy to those areas suspected of harboring residual disease on the simulation CT scan.

Results

With a median follow-up of 23 months, the two-year progression-free survival was 91.6%, and the 2- and 3-year overall survivals were 100%. We did not report any heart or lung acute side effects. The conformity index of PTV (Planning Target Volume) was better for IMRT than for 3D-CRT (p=0.001). For the breasts, lungs, heart, thyroid and esophagus, the volume distributions favored the IMRT plans. For the breasts, the V_20Gy, V_25Gy and V_30Gy were 1.5, 2.5 and 3.5 times lower, respectively, for IMRT than for 3D-CRT. For the lung tissues, the V_20Gy and V_30Gy were 2 times and 4.5 times lower, respectively, for IMRT than for 3D-CRT. For the heart, the V_20Gy and V_30Gy were 1.4 and 2 times lower, respectively, for IMRT than for 3D-CRT. For the esophagus, the V_35Gy was 1.7 lower for IMRT than for 3D-CRT, and for the thyroid, the V_30Gy was 1.2 times lower for IMRT.

Conclusion

IMRT by helical tomotherapy improved the PTV coverage and dramatically decreased the dose in organs at risk. The treatment was well tolerated, but a longer follow-up is necessary to prove a translation of these dosimetric improvements in the outcome of the patients.

【 授权许可】

   
2013 Antoni et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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