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

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

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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.

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

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Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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