PMID- 22270170
OWN - NLM
STAT- MEDLINE
DCOM- 20120816
LR  - 20120618
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 83
IP  - 4
DP  - 2012 Jul 15
TI  - Risk of developing cardiovascular disease after involved node radiotherapy versus 
      mantle field for Hodgkin lymphoma.
PG  - 1232-7
LID - 10.1016/j.ijrobp.2011.09.020 [doi]
AB  - PURPOSE: Hodgkin lymphoma (HL) survivors are known to have increased cardiac 
      mortality and morbidity. The risk of developing cardiovascular disease after 
      involved node radiotherapy (INRT) is currently unresolved, inasmuch as present 
      clinical data are derived from patients treated with the outdated mantle field 
      (MF) technique. METHODS AND MATERIALS: We included all adolescents and young 
      adults with supradiaphragmatic, clinical Stage I-II HL treated at our institution 
      from 2006 to 2010 (29 patients). All patients were treated with chemotherapy and 
      INRT to 30 to 36 Gy. We then simulated a MF plan for each patient with a 
      prescribed dose of 36 Gy. A logistic dose-response curve for the 25-year absolute 
      excess risk of cardiovascular disease was derived and applied to each patient 
      using the individual dose-volume histograms. RESULTS: The mean doses to the 
      heart, four heart valves, and coronary arteries were significantly lower for INRT 
      than for MF treatment. However, the range in doses with INRT treatment was 
      substantial, and for a subgroup of patients, with lymphoma below the fourth 
      thoracic vertebrae, we estimated a 25-year absolute excess risk of any cardiac 
      event of as much as 5.1%. CONCLUSIONS: Our study demonstrates a potential for 
      individualizing treatment by selecting the patients for whom INRT provides 
      sufficient cardiac protection for current technology; and a subgroup of patients, 
      who still receive high cardiac doses, who would benefit from more advanced 
      radiation technique.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Maraldo, Maja V
AU  - Maraldo MV
AD  - Department of Radiation Oncology, Rigshospitalet, Copenhagen, Denmark. 
      dra.maraldo@gmail.com
FAU - Brodin, Nils Patrik
AU  - Brodin NP
FAU - Vogelius, Ivan R
AU  - Vogelius IR
FAU - Aznar, Marianne C
AU  - Aznar MC
FAU - Munck Af Rosenschold, Per
AU  - Munck Af Rosenschold P
FAU - Petersen, Peter M
AU  - Petersen PM
FAU - Specht, Lena
AU  - Specht L
LA  - eng
PT  - Journal Article
DEP - 20120121
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiovascular Diseases/*etiology
MH  - Coronary Vessels/radiation effects
MH  - Dose-Response Relationship, Radiation
MH  - Female
MH  - Heart/radiation effects
MH  - Hodgkin Disease/drug therapy/pathology/*radiotherapy
MH  - Humans
MH  - Lymphatic Irradiation/adverse effects/methods
MH  - Male
MH  - Organs at Risk/*radiation effects
MH  - Radiotherapy/adverse effects/methods
MH  - Radiotherapy Dosage
MH  - Risk
MH  - Young Adult
EDAT- 2012/01/25 06:00
MHDA- 2012/08/17 06:00
CRDT- 2012/01/25 06:00
PHST- 2011/04/26 00:00 [received]
PHST- 2011/09/07 00:00 [revised]
PHST- 2011/09/09 00:00 [accepted]
PHST- 2012/01/25 06:00 [entrez]
PHST- 2012/01/25 06:00 [pubmed]
PHST- 2012/08/17 06:00 [medline]
AID - S0360-3016(11)03218-4 [pii]
AID - 10.1016/j.ijrobp.2011.09.020 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1232-7. doi: 
      10.1016/j.ijrobp.2011.09.020. Epub 2012 Jan 21.