Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits

doi:10.1016/j.ijrobp.2006.11.008

Title: Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits

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Abstract

Purpose: The challenge in early Hodgkin's disease (HD) in children is to maintain good survival rates while sparing organs at risk. This study assesses the feasibility of active breathing control (ABC) in children, and compares normal tissue irradiation with and without ABC. Methods and Materials: Between May 2003 and June 2004, seven children with HD with mediastinal involvement, median age 15, were treated by chemotherapy and involved-field radiation therapy. A free-breathing computed tomography simulation scan and one additional scan during deep inspiration using ABC were performed. A comparison between planning treatment with clinical target volume including supraclavicular regions, mediastinum, and hila was performed, both in free breathing and using ABC. Results: For a prescription of 36 Gy, pulmonary dose-volume histograms revealed a mean reduction in lung volume irradiated at more than 20 Gy (V20) and 30 Gy (V30) of 25% and 26%, respectively, using ABC (p = 0.016). The mean volume of heart irradiated at 30 Gy or more decreased from 15% to 12% (nonsignificant). The mean dose delivered to breasts in girls was small in both situations (less than 2 Gy) and stable with or without ABC. Considering axillary irradiation, the mean dose delivered to breasts remained low (<9more »« less

Authors:

Claude, Line ^[1]; Malet, Claude Phys. ^[2]; Pommier, Pascal ^[2]; Thiesse, Philippe ^[3]; Chabaud, Sylvie ^[4]; Carrie, Christian ^[2]

Department of Radiotherapy, Centre Leon Berard, Lyon (France). E-mail: claude@lyon.fnclcc.fr
Department of Radiotherapy, Centre Leon Berard, Lyon (France)
Department of Radiology, Centre Leon Berard, Lyon (France)
Department of Public Health (UBET), Centre Leon Berard, Lyon (France)

Publication Date:: Sun Apr 01 00:00:00 EDT 2007

OSTI Identifier:: 20951593

Resource Type:: Journal Article

Resource Relation:: Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.11.008; PII: S0360-3016(06)03366-9; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; CHILDREN; COMPUTERIZED TOMOGRAPHY; HEART; IRRADIATION; LUNGS; MAMMARY GLANDS; PEDIATRICS; RADIATION DOSES; RADIOTHERAPY; RESPIRATION; SIMULATION; THYROID

Citation Formats


                    Claude, Line, Malet, Claude Phys., Pommier, Pascal, Thiesse, Philippe, Chabaud, Sylvie, and Carrie, Christian. Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits.  United States: N. p., 2007. 
        Web.  doi:10.1016/j.ijrobp.2006.11.008.

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                    Claude, Line, Malet, Claude Phys., Pommier, Pascal, Thiesse, Philippe, Chabaud, Sylvie, & Carrie, Christian. Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits.  United States.  doi:10.1016/j.ijrobp.2006.11.008.

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                    Claude, Line, Malet, Claude Phys., Pommier, Pascal, Thiesse, Philippe, Chabaud, Sylvie, and Carrie, Christian. Sun .  
        "Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits".  United States.  
        doi:10.1016/j.ijrobp.2006.11.008.

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@article{osti_20951593,

  title        = {Active Breathing Control for Hodgkin's Disease in Childhood and Adolescence: Feasibility, Advantages, and Limits},

  author       = {Claude, Line and Malet, Claude Phys. and Pommier, Pascal and Thiesse, Philippe and Chabaud, Sylvie and Carrie, Christian},

  abstractNote = {Purpose: The challenge in early Hodgkin's disease (HD) in children is to maintain good survival rates while sparing organs at risk. This study assesses the feasibility of active breathing control (ABC) in children, and compares normal tissue irradiation with and without ABC. Methods and Materials: Between May 2003 and June 2004, seven children with HD with mediastinal involvement, median age 15, were treated by chemotherapy and involved-field radiation therapy. A free-breathing computed tomography simulation scan and one additional scan during deep inspiration using ABC were performed. A comparison between planning treatment with clinical target volume including supraclavicular regions, mediastinum, and hila was performed, both in free breathing and using ABC. Results: For a prescription of 36 Gy, pulmonary dose-volume histograms revealed a mean reduction in lung volume irradiated at more than 20 Gy (V20) and 30 Gy (V30) of 25% and 26%, respectively, using ABC (p = 0.016). The mean volume of heart irradiated at 30 Gy or more decreased from 15% to 12% (nonsignificant). The mean dose delivered to breasts in girls was small in both situations (less than 2 Gy) and stable with or without ABC. Considering axillary irradiation, the mean dose delivered to breasts remained low (<9 Gy), without significant difference using ABC or not. The mean radiation dose delivered to thyroid was stable using ABC or not. Conclusions: Using ABC is feasible in childhood. The use of ABC decreases normal lung tissue irradiation. Concerning heart irradiation, a minimal gain is also shown. No significant change has been demonstrated concerning breast and thyroid irradiation.},

  doi          = {10.1016/j.ijrobp.2006.11.008},

  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  number       = 5,

  volume       = 67,

  place        = {United States},

  year         = {Sun Apr 01 00:00:00 EDT 2007},

  month        = {Sun Apr 01 00:00:00 EDT 2007}

}

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DOI: 10.1016/j.ijrobp.2006.11.008

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Effect of mediastinal irradiation on cardiac function of patients treated during childhood and adolescence for Hodgkin's disease

Green, D.M. ; Gingell, R.L. ; Pearce, J. ; ... - J. Clin. Oncol.; (United States)

To determine the frequency of cardiac dysfunction in patients treated during childhood or adolescence with mediastinal irradiation for Hodgkin's disease (HD), 28 patients underwent cardiac evaluation 19 to 182 months (median, 90 months) after the completion of radiation therapy. No patient had symptoms of cardiac disease. All were normotensive. All patients had a normal cardiothoracic ratio. There were no abnormalities of voltage or rhythm in the ECGs. The left ventricular end diastolic volume was increased in 19.2% of patients, none of whom had evidence of impaired left ventricular function. The left ventricular ejection fraction (LVEF) was increased in 15.3% ofmore »« less
Active Breathing Control in Combination With Ultrasound Imaging: A Feasibility Study of Image Guidance in Stereotactic Body Radiation Therapy of Liver Lesions

Bloemen-van Gurp, Esther ; Meer, Skadi van der ; Hendry, Janet ; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: Accurate tumor positioning in stereotactic body radiation therapy (SBRT) of liver lesions is often hampered by motion and setup errors. We combined 3-dimensional ultrasound imaging (3DUS) and active breathing control (ABC) as an image guidance tool. Methods and Materials: We tested 3DUS image guidance in the SBRT treatment of liver lesions for 11 patients with 88 treatment fractions. In 5 patients, 3DUS imaging was combined with ABC. The uncertainties of US scanning and US image segmentation in liver lesions were determined with and without ABC. Results: In free breathing, the intraobserver variations were 1.4 mm in left-right (L-R), 1.6more »« less
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SU-E-T-426: Feasibility of Stereotactic Body Radiation Therapy (SBRT) Treatment of Pancreatic Cancer Using Volumetric Modulated Arc Therapy (VMAT) with Active Breathing Control (ABC)

Zhang, Y ; Jackson, J ; Davies, G ; ... - Medical Physics

Purpose: SBRT shows excellent tumor control and toxicity rates for patients with locally advanced pancreatic cancer (PCA). Herein, we evaluate the feasibility of using VMAT with ABC for PCA SBRT. Methods: Nine PCA patients previously treated via SBRT utilizing 11-beam step-and-shoot IMRT technique in our center were retrospectively identified, among whom eight patients received 3300cGy in 5 fractions while one received 3000cGy in 5 fractions. A VMAT plan was generated on each patient’s planning CT in Pinnacle v9.8 on Elekta Synergy following the same PCA SBRT clinical protocol. Three partial arcs (182°–300°, 300°-60°, and 60°-180°) with 2°/4° control-point spacing weremore »« less
DOI: 10.1118/1.4924787
Sternal changes following mediastinal irradiation for childhood Hodgkin's disease

Morris, L.L. ; Cassady, J.R. ; Jaffe, N. - Radiology, v. 115, no. 5, pp. 701-706
Gonadal status and reproductive function following treatment for Hodgkin's disease in childhood: The Stanford experience

Ortin, T.T. ; Shostak, C.A. ; Donaldson, S.S. - International Journal of Radiation Oncology, Biology and Physics; (USA)

To ascertain the impact of therapy on gonadal function and reproductive outcome among children treated for Hodgkin's disease, we reviewed the experience at Stanford University Medical Center during the years 1965-1986. There were 240 children 15 years of age or younger, 92 girls and 148 boys; with median follow-up of 9 years, maximum follow-up was 26 years. Of this cohort, data on gonadal function were available on 20 boys, 5 of whom were considered prepubescent; they had no clinical evidence of sexual maturation and were less than 13 years of age. Evaluation of the boys included testicular biopsy, semen analysesmore »« less
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