TY - JOUR
T1 - Life years lost attributable to late effects after radiotherapy for early stage Hodgkin lymphoma
T2 - The impact of proton therapy and/or deep inspiration breath hold
AU - Rechner, Laura Ann
AU - Maraldo, Maja Vestmø
AU - Vogelius, Ivan Richter
AU - Zhu, Xiaorong Ronald
AU - Dabaja, Bouthaina Shbib
AU - Brodin, Nils Patrik
AU - Petersen, Peter Meidahl
AU - Specht, Lena
AU - Aznar, Marianne Camille
N1 - Publisher Copyright:
© 2018 The Authors
PY - 2017/10
Y1 - 2017/10
N2 - Background and purpose: Due to the long life expectancy after treatment, the risk of late effects after radiotherapy (RT) is of particular importance for patients with Hodgkin lymphoma (HL). Both deep inspiration breath hold (DIBH) and proton therapy have been shown to reduce the dose to normal tissues for mediastinal HL, but the impact of these techniques in combination is unknown. The purpose of this study was to compare the life years lost (LYL) attributable to late effects after RT for mediastinal HL using intensity modulated radiation therapy (IMRT) in free breathing (FB) and DIBH, and proton therapy in FB and DIBH. Materials and methods: Plans for each technique were created for 22 patients with HL. Doses were extracted and the risk of late effects and LYL were estimated. Results: We found that the use of DIBH, proton therapy, and the combination significantly reduced the LYL compared to IMRT in FB. The lowest LYL was found for proton therapy in DIBH. However, when IMRT in DIBH was compared to proton therapy in FB, no significant difference was found. Conclusions: Patient-specific plan comparisons should be used to select the optimal technique when comparing IMRT in DIBH and proton therapy in FB.
AB - Background and purpose: Due to the long life expectancy after treatment, the risk of late effects after radiotherapy (RT) is of particular importance for patients with Hodgkin lymphoma (HL). Both deep inspiration breath hold (DIBH) and proton therapy have been shown to reduce the dose to normal tissues for mediastinal HL, but the impact of these techniques in combination is unknown. The purpose of this study was to compare the life years lost (LYL) attributable to late effects after RT for mediastinal HL using intensity modulated radiation therapy (IMRT) in free breathing (FB) and DIBH, and proton therapy in FB and DIBH. Materials and methods: Plans for each technique were created for 22 patients with HL. Doses were extracted and the risk of late effects and LYL were estimated. Results: We found that the use of DIBH, proton therapy, and the combination significantly reduced the LYL compared to IMRT in FB. The lowest LYL was found for proton therapy in DIBH. However, when IMRT in DIBH was compared to proton therapy in FB, no significant difference was found. Conclusions: Patient-specific plan comparisons should be used to select the optimal technique when comparing IMRT in DIBH and proton therapy in FB.
KW - Deep inspiration breath hold
KW - Late effects
KW - Lymphoma
KW - Proton therapy
KW - Second cancer
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U2 - 10.1016/j.radonc.2017.07.033
DO - 10.1016/j.radonc.2017.07.033
M3 - Article
C2 - 28838605
AN - SCOPUS:85027993220
SN - 0167-8140
VL - 125
SP - 41
EP - 47
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -