PMID- 23619032
OWN - NLM
STAT- MEDLINE
DCOM- 20140422
LR  - 20220409
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 24
IP  - 8
DP  - 2013 Aug
TI  - Estimated risk of cardiovascular disease and secondary cancers with modern highly 
      conformal radiotherapy for early-stage mediastinal Hodgkin lymphoma.
PG  - 2113-8
LID - 10.1093/annonc/mdt156 [doi]
AB  - BACKGROUND: Hodgkin lymphoma (HL) survivors have an increased morbidity and 
      mortality from secondary cancers and cardiovascular disease (CD). We evaluate 
      doses with involved node radiotherapy (INRT) delivered as 3D conformal 
      radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), or proton therapy 
      (PT), compared with the extensive Mantle Field (MF). PATIENTS AND METHODS: For 27 
      patients with early-stage, mediastinal HL, treated with chemotherapy and INRT 
      delivered as 3D CRT (30 Gy), we simulated an MF (36 Gy), INRT-VMAT and INRT-PT 
      (30 Gy). Dose to the heart, lungs, and breasts, estimated risks of CD, lung (LC) 
      and breast cancer (BC), and corresponding life years lost (LYL) were compared. 
      RESULTS: 3D CRT, VMAT or PT significantly lower the dose to the heart, lungs and 
      breasts and provide lower risk estimates compared with MF, but with substantial 
      patient variability. The risk of CD is not significantly different for 3D CRT 
      versus VMAT. The risk of LC and BC is highest with VMAT. For LYL, PT is the 
      superior modern technique. CONCLUSIONS: In early-stage, mediastinal HL modern 
      radiotherapy provides superior results compared with MF. However, there is no 
      single best radiotherapy technique for HL-the decision should be made at the 
      individual patient level.
FAU - Maraldo, M V
AU  - Maraldo MV
AD  - Department of Radiation Oncology, Rigshospitalet, University of Copenhagen, 
      Copenhagen, Denmark. dra.maraldo@gmail.com
FAU - Brodin, N P
AU  - Brodin NP
FAU - Aznar, M C
AU  - Aznar MC
FAU - Vogelius, I R
AU  - Vogelius IR
FAU - Munck af Rosenschold, P
AU  - Munck af Rosenschold P
FAU - Petersen, P M
AU  - Petersen PM
FAU - Specht, L
AU  - Specht L
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130425
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Breast/radiation effects
MH  - Cardiovascular Diseases/complications/*epidemiology
MH  - Female
MH  - Heart/radiation effects
MH  - Hodgkin Disease/drug therapy/*radiotherapy
MH  - Humans
MH  - Lung/radiation effects
MH  - Lymphatic Irradiation
MH  - Male
MH  - Mediastinal Neoplasms/drug therapy/*radiotherapy
MH  - Middle Aged
MH  - Neoplasms, Second Primary/*epidemiology
MH  - Organs at Risk/*radiation effects
MH  - Radiation Injuries
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - Radiotherapy, Conformal/adverse effects
MH  - Radiotherapy, Intensity-Modulated
MH  - Risk
MH  - Young Adult
OTO - NOTNLM
OT  - Hodgkin lymphoma
OT  - cardiovascular disease
OT  - highly conformal radiotherapy
OT  - involved node radiotherapy
OT  - secondary cancers
EDAT- 2013/04/27 06:00
MHDA- 2014/04/23 06:00
CRDT- 2013/04/27 06:00
PHST- 2013/04/27 06:00 [entrez]
PHST- 2013/04/27 06:00 [pubmed]
PHST- 2014/04/23 06:00 [medline]
AID - S0923-7534(19)36822-X [pii]
AID - 10.1093/annonc/mdt156 [doi]
PST - ppublish
SO  - Ann Oncol. 2013 Aug;24(8):2113-8. doi: 10.1093/annonc/mdt156. Epub 2013 Apr 25.