Scientific article
Review
English

Involved-node and involved-field volumetric modulated arc vs. fixed beam intensity-modulated radiotherapy for female patients with early-stage supra-diaphragmatic Hodgkin lymphoma: a comparative planning study

Published inInternational journal of radiation oncology, biology, physics, vol. 75, no. 5, p. 1578-1586
Publication date2009
Abstract

PURPOSE: A comparative treatment planning study was performed to compare volumetric-modulated arc (RA) to conventional intensity modulated (IMRT) for involved-field (IFRT) and involved-node (INRT) radiotherapy for Hodgkin lymphoma (HL). METHODS AND MATERIALS: Plans for 10 early-stage HL female patients were computed for RA and IMRT. First, the planning target volume (PTV) coverage and organs at risk (OAR) dose deposition was assessed between the two modalities. Second, the OAR (lung, breast, heart, thyroid, and submandibular gland) dose-volume histograms were computed and compared for IFRT and INRT, respectively. RESULTS: For IFRT and INRT, PTV coverage was equally homogeneous with both RA and IMRT. By and large, the OAR irradiation with IFRT planning was not significantly different between RA and IMRT. For INRT, doses computed for RA were, however, usually lower than those with IMRT, particularly so for the lung, breast, and thyroid. Regardless of RA and IMRT modalities, a significant 20-50% decrease of the OAR computed mean doses was observed with INRT when compared with IFRT (Breast D(Mean) 1.5 +/- 1.1 vs. 2.6 +/- 1.7 Gy, p < 0.01 and 1.6 +/- 1.1 vs. 2.9 +/- 1.9 Gy, p < 0.01 for RA and IMRT, respectively). CONCLUSIONS: RA and IMRT results in similar level of dose homogeneity. With INRT but not IFRT planning, the computed doses to the PTV and OAR were usually higher and lower with RA when compared to IMRT. Regardless of the treatment modality, INRT when compared with IFRT planning led to a significant decrease in OAR doses, particularly so for the breast and heart.

Keywords
  • Adult
  • Breast/radiation effects
  • Diaphragm/radiography
  • Female
  • Heart/radiation effects/radiography
  • Hodgkin Disease/pathology/radiography/*radiotherapy
  • Humans
  • Lung/radiation effects/radiography
  • Mammography
  • Radiation Injuries/prevention & control
  • Radiotherapy Planning, Computer-Assisted/*methods
  • Radiotherapy, Intensity-Modulated/*methods
  • Submandibular Gland/radiation effects
  • Technology, Radiologic/methods
  • Thyroid Gland/radiation effects
  • Tomography, X-Ray Computed
  • Tumor Burden
Citation (ISO format)
WEBER, Damien et al. Involved-node and involved-field volumetric modulated arc vs. fixed beam intensity-modulated radiotherapy for female patients with early-stage supra-diaphragmatic Hodgkin lymphoma: a comparative planning study. In: International journal of radiation oncology, biology, physics, 2009, vol. 75, n° 5, p. 1578–1586. doi: 10.1016/j.ijrobp.2009.05.012
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Journal ISSN0360-3016
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