Clinical impact of FDG-PET/CT in the planning of radiotherapy for early-stage Hodgkin lymphoma

Martin Hutchings, Annika Loft, Mads Hansen, Anne Kiil Berthelsen, Lena Specht, Martin Hutchings, Annika Loft Jakobsen, Mads Hansen, Anne Kiil Berthelsen, Lena Specht

    90 Citations (Scopus)

    Abstract

    BACKGROUND: Early-stage Hodgkin lymphoma (HL) has excellent survival rates but carries a high risk of late treatment-related adverse effects. Modern, individualised therapeutic strategies require an accurate determination of the extent of the disease. This study investigated the potential impact of 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computerised tomogrpahy (FDG-PET/CT) in the planning of involved field radiotherapy (IFRT). PATIENTS AND METHODS: Thirty patients received staging FDG-PET/CT before therapy, and IFRT after a short course of ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy. IFRT planning was performed using only the CT data from the FDG-PET/CT scan. Later, the IFRT planning was performed anew using the FDG-PET/CT data as basis for contouring. RESULTS: In 20 out of 30 patients, the radiotherapy (RT) course was unaffected by the addition of FDG-PET/CT. FDG-PET/CT would have increased the irradiated volume in seven patients where the volume receiving a minimum of 90% of the target dose was increased by 8-87%. FDG-PET/CT decreased the volume in two patients where the volume was reduced by 18% and 30%. CONCLUSIONS: When used for RT planning, FDG-PET/CT results in larger IFRT treatment volumes. If FDG-PET/CT is introduced to RT planning, the method should be accompanied by a change in RT treatment strategy, aiming at more targeted therapy in order to best avoid radiation to normal tissues.
    Original languageEnglish
    JournalEuropean Journal of Haematology
    Volume78
    Issue number3
    Pages (from-to)206-12
    Number of pages7
    ISSN0902-4441
    DOIs
    Publication statusPublished - 1 Mar 2007

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