PMID- 22079733
OWN - NLM
STAT- MEDLINE
DCOM- 20120618
LR  - 20120420
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 83
IP  - 1
DP  - 2012 May 1
TI  - Radiotherapy for early mediastinal Hodgkin lymphoma according to the German 
      Hodgkin Study Group (GHSG): the roles of intensity-modulated radiotherapy and 
      involved-node radiotherapy.
PG  - 268-76
LID - 10.1016/j.ijrobp.2011.05.054 [doi]
AB  - PURPOSE: Cure rates of early Hodgkin lymphoma (HL) are high, and avoidance of 
      late complications and second malignancies have become increasingly important. 
      This comparative treatment planning study analyzes to what extent target volume 
      reduction to involved-node (IN) and intensity-modulated (IM) radiotherapy (RT), 
      compared with involved-field (IF) and three-dimensional (3D) RT, can reduce doses 
      to organs at risk (OAR). METHODS AND MATERIALS: Based on 20 computed tomography 
      (CT) datasets of patients with early unfavorable mediastinal HL, we created 
      treatment plans for 3D-RT and IMRT for both the IF and IN according to the 
      guidelines of the German Hodgkin Study Group (GHSG). As OAR, we defined heart, 
      lung, breasts, and spinal cord. Dose-volume histograms (DVHs) were evaluated for 
      planning target volumes (PTVs) and OAR. RESULTS: Average IF-PTV and IN-PTV were 
      1705 cm(3) and 1015 cm(3), respectively. Mean doses to the PTVs were almost 
      identical for all plans. For IF-PTV/IN-PTV, conformity was better with IMRT and 
      homogeneity was better with 3D-RT. Mean doses to the heart (17.94/9.19 Gy for 
      3D-RT and 13.76/7.42 Gy for IMRT) and spinal cord (23.93/13.78 Gy for 3D-RT and 
      19.16/11.55 Gy for IMRT) were reduced by IMRT, whereas mean doses to lung 
      (10.62/8.57 Gy for 3D-RT and 12.77/9.64 Gy for IMRT) and breasts (left 4.37/3.42 
      Gy for 3D-RT and 6.04/4.59 Gy for IMRT, and right 2.30/1.63 Gy for 3D-RT and 
      5.37/3.53 Gy for IMRT) were increased. Volume exposed to high doses was smaller 
      for IMRT, whereas volume exposed to low doses was smaller for 3D-RT. Pronounced 
      benefits of IMRT were observed for patients with lymph nodes anterior to the 
      heart. IN-RT achieved substantially better values than IF-RT for almost all OAR 
      parameters, i.e., dose reduction of 20% to 50%, regardless of radiation 
      technique. CONCLUSIONS: Reduction of target volume to IN most effectively 
      improves OAR sparing, but is still considered investigational. For the time 
      being, IMRT should be considered for large PTVs especially when the anterior 
      mediastinum is involved.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Koeck, Julia
AU  - Koeck J
AD  - Department of Radiation Oncology, University Medical Center Mannheim, University 
      of Heidelberg, Mannheim, Germany. Julia_Koeck@gmx.net
FAU - Abo-Madyan, Yasser
AU  - Abo-Madyan Y
FAU - Lohr, Frank
AU  - Lohr F
FAU - Stieler, Florian
AU  - Stieler F
FAU - Kriz, Jan
AU  - Kriz J
FAU - Mueller, Rolf-Peter
AU  - Mueller RP
FAU - Wenz, Frederik
AU  - Wenz F
FAU - Eich, Hans Theodor
AU  - Eich HT
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20111111
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Algorithms
MH  - Breast/anatomy & histology/radiation effects
MH  - Female
MH  - Germany
MH  - Heart/radiation effects
MH  - Hodgkin Disease/pathology/*radiotherapy
MH  - Humans
MH  - Lung/radiation effects
MH  - Lymphatic Irradiation/methods/*standards
MH  - Lymphatic Metastasis
MH  - Male
MH  - Monte Carlo Method
MH  - Organ Sparing Treatments/methods
MH  - Organs at Risk/*radiation effects
MH  - Practice Guidelines as Topic/standards
MH  - Radiation Injuries/*prevention & control
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods/*standards
MH  - Radiotherapy, Conformal/methods/standards
MH  - Radiotherapy, Intensity-Modulated/methods/*standards
MH  - Spinal Cord/radiation effects
EDAT- 2011/11/15 06:00
MHDA- 2012/06/19 06:00
CRDT- 2011/11/15 06:00
PHST- 2011/04/18 00:00 [received]
PHST- 2011/05/27 00:00 [accepted]
PHST- 2011/11/15 06:00 [entrez]
PHST- 2011/11/15 06:00 [pubmed]
PHST- 2012/06/19 06:00 [medline]
AID - S0360-3016(11)02801-X [pii]
AID - 10.1016/j.ijrobp.2011.05.054 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):268-76. doi: 
      10.1016/j.ijrobp.2011.05.054. Epub 2011 Nov 11.