Active breathing control for Hodgkin's disease in childhood and adolescence: Feasibility, advantages, and limits

被引:25
作者
Claude, Line
Malet, Claude
Pommier, Pascal
Thiesse, Philippe
Chabaud, Sylvie
Carrie, Christian
机构
[1] Ctr Leon Berard, Dept Radiotherapy, F-69008 Lyon, France
[2] Ctr Leon Berard, Dept Radiol, F-69008 Lyon, France
[3] Ctr Leon Berard, Dept Publ Hlth UBET, F-69008 Lyon, France
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2007年 / 67卷 / 05期
关键词
Hodgkin's disease; pediatric; radiotherapy; active breathing control; sequelae;
D O I
10.1016/j.ijrobp.2006.11.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The challenge in early Hodgkin's disease (HD) in children is to maintain good survival rates while sparing organs at risk. This study assesses the feasibility of active breathing control (ABC) in children, and compares normal tissue irradiation with and without ABC. Methods and Materials: Between May 2003 and June 2004, seven children with HD with mediastinal involvement, median age 15, were treated by chemotherapy and involved-field radiation therapy. A free-breathing computed tomography simulation scan and one additional scan during deep inspiration using ABC were performed. A comparison between planning treatment with clinical target volume including supraclavicular regions, mediastinum, and hila was performed, both in free breathing and using ABC. Results: For a prescription of 36 Gy, pulmonary dose-volume histograms revealed a mean reduction in lung volume irradiated at more than 20 Gy (V20) and 30 Gy (V30) of 25% and 26%, respectively, using ABC (p = 0.016). The mean volume of heart irradiated at 30 Gy or more decreased from 15% to 12% (nonsignificant). The mean dose delivered to breasts in girls was small in both situations (less than 2 Gy) and stable with or without ABC. Considering axillary irradiation, the mean dose delivered to breasts remained low (<9 Gy), without significant difference using ABC or not. The mean radiation dose delivered to thyroid was stable using ABC or not. Conclusions: Using ABC is feasible in childhood. The use of ABC decreases normal lung tissue irradiation. Concerning heart irradiation, a minimal gain is also shown. No significant change has been demonstrated concerning breast and thyroid irradiation. (c) 2007 Elsevier Inc.
引用
收藏
页码:1470 / 1475
页数:6
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