title: Dosimetric and clinical outcomes of involved-field intensity-modulated radiotherapy after chemotherapy for early-stage Hodgkin's lymphoma with mediastinal involvement.
abstract: OBJECTIVE
  To evaluate the dosimetric and clinical outcomes of involved-field intensity-modulated radiotherapy (IF-IMRT) for patients with early-stage Hodgkin's lymphoma (HL) with mediastinal involvement.
  
  
  METHODS
  Fifty-two patients with early-stage HL that involved the mediastinum were reviewed. Eight patients had Stage I disease, and 44 patients had Stage II disease. Twenty-three patients (44%) presented with a bulky mediastinum, whereas 42 patients (81%) had involvement of both the mediastinum and either cervical or axillary nodes. All patients received combination chemotherapy followed by IF-IMRT. The prescribed radiation dose was 30-40 Gy. The dose-volume histograms of the target volume and critical normal structures were evaluated.
  
  
  RESULTS
  The median mean dose to the primary involved regions (planning target volume, PTV1) and boost area (PTV2) was 37.5 Gy and 42.1 Gy, respectively. Only 0.4% and 1.3% of the PTV1 and 0.1% and 0.5% of the PTV2 received less than 90% and 95% of the prescribed dose, indicating excellent PTV coverage. The median mean lung dose and V20 to the lungs were 13.8 Gy and 25.9%, respectively. The 3-year overall survival, local control, and progression-free survival rates were 100%, 97.9%, and 96%, respectively. No Grade 4 or 5 acute or late toxicities were reported.
  
  
  CONCLUSIONS
  Despite the large target volume, IF-IMRT gave excellent dose coverage and a favorable prognosis, with mild toxicity in patients with early-stage mediastinal HL.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Ning-Ning
authors.initials: NN
authors.lastname: Lu
authors.forename: Ye-Xiong
authors.initials: YX
authors.lastname: Li
authors.forename: Run-Ye
authors.initials: RY
authors.lastname: Wu
authors.forename: Xi-Mei
authors.initials: XM
authors.lastname: Zhang
authors.forename: Wei-Hu
authors.initials: WH
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.forename: Yong-Wen
authors.initials: YW
authors.lastname: Song
authors.forename: Hui
authors.initials: H
authors.lastname: Fang
authors.forename: Hua
authors.initials: H
authors.lastname: Ren
authors.forename: Shu-Lian
authors.initials: SL
authors.lastname: Wang
authors.forename: Yue-Ping
authors.initials: YP
authors.lastname: Liu
authors.forename: Xin-Fan
authors.initials: XF
authors.lastname: Liu
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Dai
authors.forename: Zi-Hao
authors.initials: ZH
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D003606:Dacarbazine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008168:Lung / Q000528:radiation effects; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D058958:Organs at Risk / Q000528:radiation effects; D011832:Radiation Injuries / Q000473:pathology; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D015996:Survival Rate; D047368:Tumor Burden; D014747:Vinblastine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin