Intensity-modulated radiotherapy for lymphoma involving the mediastinum
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
Purpose: To determine the feasibility, potential advantage, and indications for intensity-modulated radiotherapy (IMRT) in the treatment of Hodgkin's lymphoma or non-Hodgkin's lymphoma involving excessively large mediastinal disease volumes or requiring repeat RT. Methods and materials: Sixteen patients with Hodgkin's lymphoma (n = 11) or non-Hodgkin's lymphoma (n = 5) undergoing primary radiotherapy or repeat RT delivered via an IMRT plan were studied. The indications for using an IMRT plan were previous mediastinal RT (n = 5) or extremely large mediastinal treatment volumes (n 11). For each patient, IMRT, conventional parallel-opposed (AP-PA), and three-dimensional conformal (3D-CRT) plans were designed using 6-MV X-rays to deliver doses ranging from 18 to 45 Gy (median, 36 Gy). The plans were compared with regard to dose-volume parameters. The IMRT/AP-PA and IMRT/3D-CRT ratios were calculated for each parameter. Results: For all patients, the mean lung dose was reduced using IMRT, on average, by 12% compared with AP-PA and 14% compared with 3D-CRT. The planning target volume coverage was also improved using IMRT compared with AP-PA but was not different from the planning target volume coverage obtained with 3D-CRT. Conclusion: In selected patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma involving the mediastinum, IMRT provides improved planning target volume coverage and reduces pulmonary toxicity parameters. It is feasible for RT of large treatment volumes and allows repeat RT of relapsed disease without exceeding cord tolerance. Additional follow-up is necessary to determine whether improvements in dose delivery affect long-term morbidity and disease control.
- OSTI ID:
- 20698428
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 62, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2004.08.048; PII: S0360-3016(04)02469-1; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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