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Title: Role of FDG-PET in the Implementation of Involved-Node Radiation Therapy for Hodgkin Lymphoma Patients

Purpose: This study examines the role of {sup 18}F-labeled fluorodeoxyglucose positron emission tomography (FDG-PET) in the implementation of involved-node radiation therapy (INRT) in patients treated for clinical stages (CS) I/II supradiaphragmatic Hodgkin lymphoma (HL). Methods and Material: Patients with untreated CS I/II HL enrolled in the randomized EORTC/LYSA/FIL Intergroup H10 trial and participating in a real-time prospective quality assurance program were prospectively included in this study. Data were electronically obtained from 18 French cancer centers. All patients underwent APET-computed tomography (PET-CT) and a post-chemotherapy planning CT scanning. The pre-chemotherapy gross tumor volume (GTV) and the postchemotherapy clinical target volume (CTV) were first delineated on CT only by the radiation oncologist. The planning PET was then co-registered, and the delineated volumes were jointly analyzed by the radiation oncologist and the nuclear medicine physician. Lymph nodes undetected on CT but FDG-avid were recorded, and the previously determined GTV and CTV were modified according to FDG-PET results. Results: From March 2007 to February 2010, 135 patients were included in the study. PET-CT identified at least 1 additional FDG-avid lymph node in 95 of 135 patients (70.4%; 95% confidence interval [CI]: 61.9%-77.9%) and 1 additional lymph node area in 55 of 135 patients (40.7%; 95%more » CI: 32.4%-49.5%). The mean increases in the GTV and CTV were 8.8% and 7.1%, respectively. The systematic addition of PET to CT led to a CTV increase in 60% of the patients. Conclusions: Pre-chemotherapy FDG-PET leads to significantly better INRT delineation without necessarily increasing radiation volumes.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [3] ;  [5] ;  [6] ;  [7] ;  [2] ;  [7]
  1. Department of Radiotherapy, Institut Gustave Roussy, Villejuif (France)
  2. Department of Biostatistics and Epidemiology, Institut Gustave Roussy, Villejuif (France)
  3. Department of Medicine, Institut Gustave Roussy, Villejuif (France)
  4. Department of Imaging, Institut Gustave Roussy, Villejuif (France)
  5. Department of Medical Physics, Institut Gustave Roussy, Villejuif (France)
  6. Department of Information Technology, Institut Gustave Roussy, Villejuif (France)
  7. Department of Imaging, Institut Curie R. Huguenin Hospital, Saint-Cloud (France)
Publication Date:
OSTI Identifier:
22420392
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 89; Journal Issue: 5; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The 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; CAT SCANNING; CHEMOTHERAPY; FLUORINE 18; FLUORODEOXYGLUCOSE; HODGKINS DISEASE; LYMPH NODES; MEDICAL PERSONNEL; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; QUALITY ASSURANCE; RADIOTHERAPY