Erschienen in:
01.09.2015 | Original Article
Breath-hold technique in conventional APPA or intensity-modulated radiotherapy for Hodgkin’s lymphoma
Comparison of ILROG IS-RT and the GHSG IF-RT
verfasst von:
Jan Kriz, M.D., Max Spickermann, Philipp Lehrich, Heinz Schmidberger, M.D., PhD., Gabriele Reinartz, M.D., Hans Eich, M.D., PhD., Uwe Haverkamp, M.D., PhD.
Erschienen in:
Strahlentherapie und Onkologie
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Ausgabe 9/2015
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Abstract
Introduction
The present study addresses the role of intensity-modulated radiotherapy (IMRT) in contrast to standard RT (APPA) for patients with Hodgkin’s lymphoma (HL) with a focus on deep inspiration breath-hold (DIBH) technique and a comparison between the International Lymphoma Radiation Oncology Group (ILROG) Involved Site Radiotherapy (IS-RT) versus the German Hodgkin Study Group (GHSG) Involved Field Radiotherapy (IF-RT).
Methods
APPA treatment and 2 IMRT plans were compared for 11 patients with HL. Furthermore, treatment with DIBH versus free breathing (FB) and two different treatment volumes, i.e. IF-RT versus IS-RT, were compared. IMRT was planned as a sliding-window technique with 5 and 7 beam angles. For each patient 12 different treatment plans were calculated (132 plans). Following organs at risk (OAR) were analysed: lung, heart, spinal cord, oesophagus, female breast and skin. Comparisons of the different values with regard to dose–volume histograms (DVH), conformity and homogeneity indices were made.
Results
IS-RT reduces treatment volumes. With respect to the planning target volume (PTV), IMRT achieves better conformity but the same homogeneity. Regarding the Dmean for the lung, IMRT shows increased doses, while RT in DIBH reduces doses. The IMRT shows improved values for Dmax concerning the spinal cord, whereas the APPA shows an improved Dmean of the lung and the female breast.
Conclusion
IS-RT reduces treatment volumes. Intensity-modulated radiotherapy shows advantages in the conformity. Treatment in DIBH also reduces the dose applied to the lungs and the heart.