Abstract
Purpose
To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin
lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal
radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated
proton therapy (PT), in comparison to the past mantle field (MF).
Materials and methods
Data from 37 patients with cervical lymph node involvement were used. All patients
originally received chemotherapy followed by 3DCRT–INRT (30.6 Gy). A VMAT–INRT, PT–INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs
and repeated measures ANOVA.
Results
The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p < 0.0001), respectively.
Conclusion
The use of INRT significantly lowered the estimated radiation dose to the head and
neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients,
PT offered an additional gain.
Keywords
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Article info
Publication history
Published online: November 04, 2013
Accepted:
September 1,
2013
Received in revised form:
August 28,
2013
Received:
June 25,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
