A Systematic Review on Intensity Modulated Radiation Therapy for Mediastinal Hodgkin's Lymphoma.

Hodgkin Disease / radiotherapy Humans Mediastinal Neoplasms / radiotherapy Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted Radiotherapy, Conformal Radiotherapy, Intensity-Modulated / adverse effects
IMRT cardiovascular conformal intensity modulated lymphoma mediastinal radiotherapy secondary cancer

Journal

Critical reviews in oncology/hematology
ISSN: 1879-0461
Titre abrégé: Crit Rev Oncol Hematol
Pays: Netherlands
ID NLM: 8916049

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 08 08 2020
revised: 20 05 2021
accepted: 28 07 2021
pubmed: 7 8 2021
medline: 16 11 2021
entrez: 6 8 2021
Statut: ppublish

Résumé

Secondary malignant neoplasms (SMNs) and cardiovascular diseases induced by chemotherapy and radiotherapy represent the main cause of excess mortality for early-stage Hodgkin lymphoma patients, especially when the mediastinum is involved. Conformal radiotherapy techniques such as Intensity-Modulated Radiation Therapy (IMRT) could allow a reduction of the dose to the organs-at-risk (OARs) and therefore limit long-term toxicity. We performed a systematic review of the current literature regarding comparisons between IMRT and conventional photon beam radiotherapy, or between different IMRT techniques, for the treatment of mediastinal lymphoma. IMRT allows a substantial reduction of the volumes of OARs exposed to high doses, reducing the risk of long-term toxicity. This benefit is conterbalanced by the increase of volumes receiving low doses, that could potentially increase the risk of SMNs. Treatment planning should be personalized on patient and disease characteristics. Dedicated techniques such as "butterfly" VMAT often provide the best trade-off.

Sections du résumé

BACKGROUND BACKGROUND
Secondary malignant neoplasms (SMNs) and cardiovascular diseases induced by chemotherapy and radiotherapy represent the main cause of excess mortality for early-stage Hodgkin lymphoma patients, especially when the mediastinum is involved. Conformal radiotherapy techniques such as Intensity-Modulated Radiation Therapy (IMRT) could allow a reduction of the dose to the organs-at-risk (OARs) and therefore limit long-term toxicity.
METHODS METHODS
We performed a systematic review of the current literature regarding comparisons between IMRT and conventional photon beam radiotherapy, or between different IMRT techniques, for the treatment of mediastinal lymphoma.
RESULTS AND CONCLUSIONS CONCLUSIONS
IMRT allows a substantial reduction of the volumes of OARs exposed to high doses, reducing the risk of long-term toxicity. This benefit is conterbalanced by the increase of volumes receiving low doses, that could potentially increase the risk of SMNs. Treatment planning should be personalized on patient and disease characteristics. Dedicated techniques such as "butterfly" VMAT often provide the best trade-off.

Identifiants

DOI: 10.1016/j.critrevonc.2021.103437 PMID: 34358649
pubmed: 34358649
pii: S1040-8428(21)00225-0
doi: 10.1016/j.critrevonc.2021.103437
pii:
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

103437

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Michela Buglione (M)

Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: michela.buglione@unibs.it.

Andrea Emanuele Guerini (AE)

Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: a.e.guerini@gmail.com.

Andrea Riccardo Filippi (AR)

Radiation Oncology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy. Electronic address: a.filippi@smatteo.pv.it.

Luigi Spiazzi (L)

Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: luigi.spiazzi@asst-spedalicivili.it.

Nadia Pasinetti (N)

Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy; Radiation Oncology Service, ASST Valcamonica Esine, Italy. Electronic address: nadia.pasinetti@aol.com.

Alessandro Magli (A)

Department of Radiation Oncology, Udine General Hospital, Udine, Italy. Electronic address: maglialessandro@hotmail.com.

Cristian Toraci (C)

Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: c.toraci@gmail.com.

Paolo Borghetti (P)

Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: paolobor82@yahoo.it.

Luca Triggiani (L)

Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: triggioluca@hotmail.it.

Alessandro Alghisi (A)

Department of Radiation Oncology, Alessandro Manzoni Hospital, Lecco, Italy. Electronic address: ale.alghisi@libero.it.

Gianluca Costantino (G)

Radiation Oncology Service, ASST Valcamonica Esine, Italy. Electronic address: costantino.gianlu@gmail.com.

Francesco Bertagna (F)

Nuclear Medicine Department, University of Brescia and Spedali Civili of Brescia, Brescia, Italy. Electronic address: francesco.bertagna@unibs.it.

Niccolò Giaj Levra (N)

Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Italy. Electronic address: gmnicco@yahoo.it.

Ludovica Pegurri (L)

Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: ludovicapegurri@libero.it.

Stefano Maria Magrini (SM)

Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy. Electronic address: stefano.magrini@unibs.it.

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Classifications MeSH

questionsmedicales.fr › Maladies du système immunitaire › Syndromes immunoprolifératifs › Syndromes lymphoprolifératifs › Lymphomes › Maladie de Hodgkin › A Systematic Review on Intensity Modulated...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A Systematic Review on Intensity Modulated...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Maladies du thorax › Maladies du médiastin › Tumeurs du médiastin › A Systematic Review on Intensity Modulated...
questionsmedicales.fr › Thérapeutique › Radiothérapie › Dosimétrie en radiothérapie › A Systematic Review on Intensity Modulated...
questionsmedicales.fr › Sciences de l'information › Informatique › Informatique médicale › Applications de l'informatique médicale › Prise de décision assistée par ordinateur › Thérapie assistée par ordinateur › Radiothérapie assistée par ordinateur › Planification de radiothérapie assistée par ordinateur › A Systematic Review on Intensity Modulated...
questionsmedicales.fr › Sciences de l'information › Informatique › Informatique médicale › Applications de l'informatique médicale › Prise de décision assistée par ordinateur › Thérapie assistée par ordinateur › Radiothérapie assistée par ordinateur › Radiothérapie conformationnelle › A Systematic Review on Intensity Modulated...
questionsmedicales.fr › Sciences de l'information › Informatique › Informatique médicale › Applications de l'informatique médicale › Prise de décision assistée par ordinateur › Thérapie assistée par ordinateur › Radiothérapie assistée par ordinateur › Radiothérapie conformationnelle › Radiothérapie conformationnelle avec modulation d'intensité › A Systematic Review on Intensity Modulated...