Radiation for Hodgkin's lymphoma in young female patients: a new technique to avoid the breasts and decrease the dose to the heart.
OBJECTIVE
To demonstrate how, in young female patients with Hodgkin's lymphoma, using an inclined board technique can further decrease the volume of breasts and heart in the treatment field.


METHODS
An inclined board was constructed with the ability to mount an Aquaplast face mask, a Vacu-Lock, and a hip stopper. Eight female patients with early-stage Hodgkin's lymphoma were planned and compared using the conventional flat position and the inclined board position. All patients on the inclined board were planned with 90° degree table position and 15° gantry angle rotation to compensate for the beam divergence resulting from the patient's position on the inclined board. Dose-volume histograms were generated, as well as the mean V30 and V5 of both breasts and heart using both treatment positions.


RESULTS
The mean value of V30 of the right breast, left breast, and heart decreased from 3%, 3%, and 13%, respectively, using the flat position to 0, 0.4%, and 5%, respectively, using the inclined board. The mean value of V5 of the right breast, left breast, and heart decreased from 6%, 13%, and 36%, respectively, using the flat position to 2%, 8%, and 29%, respectively, using the inclined board.


CONCLUSIONS
Compared with conventional flat positioning, this simple device and technique allows better sparing of the breasts and the heart while maintaining comparable target coverage and total lung dose.
Dabaja
Bouthaina S
BS
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. bdabaja@mdanderson.org
Rebueno
Neal C S
NC
Mazloom
Ali
A
Thorne
Scott
S
Perrin
Kelly J
KJ
Tolani
Naresh
N
Das
Pragnan
P
Delclos
Marc E
ME
Iyengar
Puneeth
P
Reed
Valerie K
VK
Horace
Patrecia
P
Salehpour
Mohammad R
MR
D001940:Breast / Q000528:radiation effects*; D005260:Female; D006321:Heart / Q000528:radiation effects*; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D058958:Organs at Risk / Q000528:radiation effects; D056888:Patient Positioning / Q000295:instrumentation / Q000379:methods*; D011832:Radiation Injuries / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed; D055815:Young Adult