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Radiation therapy planning for early-stage Hodgkin lymphoma: experience of the International Lymphoma Radiation Oncology Group

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  1. Lymphoblastic Lymphoma: Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

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  2. Radiation in Central Nervous System Leukemia: Guidelines From the International Lymphoma Radiation Oncology Group

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  1. On the relation between improved loco-regional control and disease-free survival in head-and-neck cancer

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  2. Lymphoblastic Lymphoma: Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

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  3. Long term safety and visibility of a novel liquid fiducial marker for use in image guided radiotherapy of non-small cell lung cancer

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  4. Radiotherapy for Hodgkin Lymphoma: Reducing Toxicity While Maintaining Efficacy

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PURPOSE: Early-stage Hodgkin lymphoma (HL) is a rare disease, and the location of lymphoma varies considerably between patients. Here, we evaluate the variability of radiation therapy (RT) plans among 5 International Lymphoma Radiation Oncology Group (ILROG) centers with regard to beam arrangements, planning parameters, and estimated doses to the critical organs at risk (OARs).

METHODS: Ten patients with stage I-II classic HL with masses of different sizes and locations were selected. On the basis of the clinical information, 5 ILROG centers were asked to create RT plans to a prescribed dose of 30.6 Gy. A postchemotherapy computed tomography scan with precontoured clinical target volume (CTV) and OARs was provided for each patient. The treatment technique and planning methods were chosen according to each center's best practice in 2013.

RESULTS: Seven patients had mediastinal disease, 2 had axillary disease, and 1 had disease in the neck only. The median age at diagnosis was 34 years (range, 21-74 years), and 5 patients were male. Of the resulting 50 treatment plans, 15 were planned with volumetric modulated arc therapy (1-4 arcs), 16 with intensity modulated RT (3-9 fields), and 19 with 3-dimensional conformal RT (2-4 fields). The variations in CTV-to-planning target volume margins (5-15 mm), maximum tolerated dose (31.4-40 Gy), and plan conformity (conformity index 0-3.6) were significant. However, estimated doses to OARs were comparable between centers for each patient.

CONCLUSIONS: RT planning for HL is challenging because of the heterogeneity in size and location of disease and, additionally, to the variation in choice of treatment techniques and field arrangements. Adopting ILROG guidelines and implementing universal dose objectives could further standardize treatment techniques and contribute to lowering the dose to the surrounding OARs.

Original languageEnglish
JournalInternational Journal of Radiation: Oncology - Biology - Physics
Volume92
Issue number1
Pages (from-to)144-52
Number of pages9
ISSN0360-3016
DOIs
Publication statusPublished - 1 May 2015

    Research areas

  • Adult, Aged, Axilla, Breast, Cancer Care Facilities, Female, Head and Neck Neoplasms, Heart, Hodgkin Disease, Humans, Lung, Male, Mediastinal Neoplasms, Middle Aged, Organs at Risk, Radiation Oncology, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Conformal, Radiotherapy, Intensity-Modulated, Thyroid Gland, Young Adult

ID: 46006105