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

TY - JOUR

T1 - Clinical impact of FDG-PET/CT in the planning of radiotherapy for early-stage Hodgkin lymphoma

AU - Hutchings, Martin

AU - Loft, Annika

AU - Hansen, Mads

AU - Berthelsen, Anne Kiil

AU - Specht, Lena

AU - Hutchings, Martin

AU - Jakobsen, Annika Loft

AU - Hansen, Mads

AU - Berthelsen, Anne Kiil

AU - Specht, Lena

N1 - Keywords: Adolescent; Adult; Aged; Female; Fluorodeoxyglucose F18; Hodgkin Disease; Humans; Male; Middle Aged; Neoplasm Staging; Positron-Emission Tomography; Tomography, X-Ray Computed

PY - 2007/3/1

Y1 - 2007/3/1

N2 - 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.

AB - 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.

U2 - 10.1111/j.1600-0609.2006.00802.x

DO - 10.1111/j.1600-0609.2006.00802.x

M3 - Journal article

C2 - 17253974

SN - 0902-4441

VL - 78

SP - 206

EP - 212

JO - European Journal of Haematology

JF - European Journal of Haematology

IS - 3

ER -