Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy

M. V. Maraldo, Nils P. Brodin, M. C. Aznar, I. R. Vogelius, P. Munck Af Rosenschöld, P. M. Petersen, L. Specht

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison to the past mantle field (MF). Materials and methods Data from 37 patients with cervical lymph node involvement were used. All patients originally received chemotherapy followed by 3DCRT-INRT (30.6 Gy). A VMAT-INRT, PT-INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs and repeated measures ANOVA. Results The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p < 0.0001), respectively. Conclusion The use of INRT significantly lowered the estimated radiation dose to the head and neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients, PT offered an additional gain.

Original languageEnglish (US)
Pages (from-to)441-447
Number of pages7
JournalRadiotherapy and Oncology
Volume110
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Proton Therapy
Conformal Radiotherapy
Intensity-Modulated Radiotherapy
Hodgkin Disease
Organs at Risk
Neck
Radiotherapy
Head
Neck Muscles
Larynx
Pharynx
Analysis of Variance
Thyroid Gland
Lymph Nodes
Radiation
Drug Therapy

Keywords

  • 3DCRT
  • Hodgkin lymphoma
  • Normal tissues
  • Proton therapy
  • Radiotherapy
  • VMAT

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology
  • Medicine(all)

Cite this

Maraldo, M. V., Brodin, N. P., Aznar, M. C., Vogelius, I. R., Munck Af Rosenschöld, P., Petersen, P. M., & Specht, L. (2014). Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy. Radiotherapy and Oncology, 110(3), 441-447. https://doi.org/10.1016/j.radonc.2013.09.027

Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy. / Maraldo, M. V.; Brodin, Nils P.; Aznar, M. C.; Vogelius, I. R.; Munck Af Rosenschöld, P.; Petersen, P. M.; Specht, L.

In: Radiotherapy and Oncology, Vol. 110, No. 3, 2014, p. 441-447.

Research output: Contribution to journalArticle

Maraldo, MV, Brodin, NP, Aznar, MC, Vogelius, IR, Munck Af Rosenschöld, P, Petersen, PM & Specht, L 2014, 'Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy', Radiotherapy and Oncology, vol. 110, no. 3, pp. 441-447. https://doi.org/10.1016/j.radonc.2013.09.027
Maraldo, M. V. ; Brodin, Nils P. ; Aznar, M. C. ; Vogelius, I. R. ; Munck Af Rosenschöld, P. ; Petersen, P. M. ; Specht, L. / Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy. In: Radiotherapy and Oncology. 2014 ; Vol. 110, No. 3. pp. 441-447.
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abstract = "Purpose To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison to the past mantle field (MF). Materials and methods Data from 37 patients with cervical lymph node involvement were used. All patients originally received chemotherapy followed by 3DCRT-INRT (30.6 Gy). A VMAT-INRT, PT-INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs and repeated measures ANOVA. Results The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p < 0.0001), respectively. Conclusion The use of INRT significantly lowered the estimated radiation dose to the head and neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients, PT offered an additional gain.",
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T1 - Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy

AU - Maraldo, M. V.

AU - Brodin, Nils P.

AU - Aznar, M. C.

AU - Vogelius, I. R.

AU - Munck Af Rosenschöld, P.

AU - Petersen, P. M.

AU - Specht, L.

PY - 2014

Y1 - 2014

N2 - Purpose To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison to the past mantle field (MF). Materials and methods Data from 37 patients with cervical lymph node involvement were used. All patients originally received chemotherapy followed by 3DCRT-INRT (30.6 Gy). A VMAT-INRT, PT-INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs and repeated measures ANOVA. Results The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p < 0.0001), respectively. Conclusion The use of INRT significantly lowered the estimated radiation dose to the head and neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients, PT offered an additional gain.

AB - Purpose To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison to the past mantle field (MF). Materials and methods Data from 37 patients with cervical lymph node involvement were used. All patients originally received chemotherapy followed by 3DCRT-INRT (30.6 Gy). A VMAT-INRT, PT-INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs and repeated measures ANOVA. Results The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p < 0.0001), respectively. Conclusion The use of INRT significantly lowered the estimated radiation dose to the head and neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients, PT offered an additional gain.

KW - 3DCRT

KW - Hodgkin lymphoma

KW - Normal tissues

KW - Proton therapy

KW - Radiotherapy

KW - VMAT

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