AI Article Synopsis
- Secondary malignant neoplasms (SMNs) and cardiovascular diseases from cancer treatments are significant risks for early-stage Hodgkin lymphoma patients, particularly with mediastinal involvement.
- Conformal radiotherapy techniques like Intensity-Modulated Radiation Therapy (IMRT) can reduce exposure to organs-at-risk (OARs), potentially lowering long-term toxicity from treatments.
- IMRT effectively limits high-dose radiation to critical areas, but it may increase the volume of low-dose exposure, which could raise the risk of developing SMNs, emphasizing the need for personalized treatment plans that consider individual patient and disease factors.
Article Abstract
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: 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: 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.
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| http://dx.doi.org/10.1016/j.critrevonc.2021.103437 | DOI Listing |
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