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Author Aznar, Marianne C. ♦ Maraldo, Maja V. ♦ Schut, Deborah A. ♦ Lundemann, Michael ♦ Brodin, N. Patrik ♦ Vogelius, Ivan R. ♦ Berthelsen, Anne K. ♦ Specht, Lena ♦ Petersen, Peter M.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ BREATH ♦ CARDIOVASCULAR DISEASES ♦ COMPARATIVE EVALUATIONS ♦ HAZARDS ♦ HEART ♦ LIFETIME ♦ LUNGS ♦ LYMPHOMAS ♦ MAMMARY GLANDS ♦ PATIENTS ♦ PLANNING ♦ RADIATION DOSES ♦ RADIOTHERAPY ♦ RESPIRATION ♦ THYROID
Abstract Purpose: Hodgkin lymphoma (HL) survivors have an increased risk of cardiovascular disease (CD), lung cancer, and breast cancer. We investigated the risk for the development of CD and secondary lung, breast, and thyroid cancer after radiation therapy (RT) delivered with deep inspiration breath-hold (DIBH) compared with free-breathing (FB) using 3-dimensional conformal RT (3DCRT) and intensity modulated RT (IMRT). The aim of this study was to determine which treatment modality best reduced the combined risk of life-threatening late effects in patients with mediastinal HL. Methods and Materials: Twenty-two patients with early-stage mediastinal HL were eligible for the study. Treatment plans were calculated with both 3DCRT and IMRT on both DIBH and FB planning computed tomographic scans. We reported the estimated dose to the heart, lung, female breasts, and thyroid and calculated the estimated life years lost attributable to CD and to lung, breast, and thyroid cancer. Results: DIBH lowered the estimated dose to heart and lung regardless of delivery technique (P<.001). There was no significant difference between IMRT-FB and 3DCRT-DIBH in mean heart dose, heart V20Gy, and lung V20Gy. The mean breast dose was increased with IMRT regardless of breathing technique. Life years lost was lowest with DIBH and highest with FB. Conclusions: In this cohort, 3DCRT-DIBH resulted in lower estimated doses and lower lifetime excess risks than did IMRT-FB. Combining IMRT and DIBH could be beneficial for a subgroup of patients.
ISSN 03603016
Educational Use Research
Learning Resource Type Article
Publisher Date 2015-05-01
Publisher Place United States
Journal International Journal of Radiation Oncology, Biology and Physics
Volume Number 92
Issue Number 1


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