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Helical tomotherapy in the radiotherapy treatment of Hodgkin's disease ‐ a feasibility study

Journal of applied clinical medical physics, 2010-01, Vol.11 (1), p.77-87 [Peer Reviewed Journal]

2010 The Authors. ;2010. This work is published under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 1526-9914 ;EISSN: 1526-9914 ;DOI: 10.1120/jacmp.v11i1.3042 ;PMID: 20160691

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Title:
Helical tomotherapy in the radiotherapy treatment of Hodgkin's disease ‐ a feasibility study
Author: Vlachaki, Maria T. ; Kumar, Sanath
Subjects: 3D CRT ; Adolescent ; Axilla - radiation effects ; Breast - radiation effects ; Chemotherapy ; Feasibility Studies ; Female ; Heart ; Heart - radiation effects ; Helical TomoTherapy ; Hodgkin Disease - pathology ; Hodgkin Disease - radiotherapy ; Hodgkin's Disease ; Humans ; Imaging, Three-Dimensional ; Lung - radiation effects ; Lungs ; Lymph Nodes - pathology ; Lymph Nodes - radiation effects ; Lymphatic system ; Medical imaging ; Models, Biological ; Pediatrics ; Pericardial Effusion - metabolism ; Pericardial Effusion - pathology ; Planning ; Pleural Effusion - metabolism ; Pleural Effusion - pathology ; Radiation Injuries ; Radiation Oncology Physics ; Radiation therapy ; Radiometry ; Radiotherapy Dosage ; Radiotherapy, Conformal - instrumentation ; Radiotherapy, Conformal - methods ; Thyroid Gland - radiation effects ; Tomography, Spiral Computed - instrumentation ; Tomography, Spiral Computed - methods
Is Part Of: Journal of applied clinical medical physics, 2010-01, Vol.11 (1), p.77-87
Description: Radiation therapy for advanced Hodgkin's disease often requires large fields and may result in significant exposure of normal tissues to ionizing radiation. In long‐term survivors, this may increase the risk for late toxicity including secondary malignancies. 3D CRT has been successfully used to treat this disease but treatment delivery is often complex requiring matching of photon with electron beams, and utilization of field‐in‐field techniques and of partial transmission blocks. HT is an arc‐rotational intensity modulated radiation therapy technique proven to achieve superior target dose conformality and sharp dose gradients around critical normal tissues. HT, however, has also been associated with higher volumes of low‐dose regions in normal tissues and, therefore, higher integral dose. The present study was undertaken to compare the dosimetry of 3D CRT to HT in a pediatric patient with advanced HD. Clinical target volume (CTV) included bilateral lower cervical and supraclavicular areas, mediastinum, bilateral hili, left axilla and bilateral diaphragmatic lymph nodes. The planning target volume (PTV) was derived by circumferentially expanding the CTV by 1 cm. Whole lung and heart irradiation was also planned due to bilateral pleural and pericardial effusions. The prescribed radiation dose was 21 Gy to the PTV and 10.5 Gy to the whole lung and heart. Target coverage was comparable for both plans. The minimum, maximum, and mean PTV doses were 18.61 Gy, 22.45 Gy and 21.52 Gy with 3D CRT and 19.85 Gy, 22.36 Gy and 21.39 Gy with HT, respectively. HT decreased mean normal tissue dose by 21.6% and 20.07% for right and left breast, 20.40% for lung, 30.78% for heart, and 22.74% for the thyroid gland. Integral dose also decreased with HT by 46.50%. HT results in significant dosimetric gain related to normal tissue sparing compared to 3D CRT. Further studies are warranted to evaluate clinical applications of HT in patients with HD. PACS number: 87.53.Kn
Publisher: United States: John Wiley & Sons, Inc
Language: English
Identifier: ISSN: 1526-9914
EISSN: 1526-9914
DOI: 10.1120/jacmp.v11i1.3042
PMID: 20160691
Source: Open Access: Wiley Blackwell Open Access Journals
AUTh Library subscriptions: ProQuest Central
GFMER Free Medical Journals
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PubMed Central
ROAD: Directory of Open Access Scholarly Resources
DOAJ Directory of Open Access Journals

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Helical tomotherapy in the radiotherapy treatment of Hodgkin's disease ‐ a feasibility study

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