Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines

TY - JOUR

T1 - Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines

AU - Girinsky, Theodore

AU - van der Maazen, Richard

AU - Specht, Lena

AU - Aleman, Berthe

AU - Poortmans, Philip

AU - Lievens, Yolande

AU - Meijnders, Paul

AU - Ghalibafian, Mithra

AU - Meerwaldt, Jacobus

AU - Noordijk, Evert

N1 - Keywords: Combined Modality Therapy; Dose-Response Relationship, Radiation; Europe; Hodgkin Disease; Humans; Lymph Nodes; Practice Guidelines as Topic; Radiotherapy, Conformal

PY - 2006

Y1 - 2006

N2 - BACKGROUND AND PURPOSE: To describe new concepts for radiation fields in patients with early stage Hodgkin lymphoma treated with a combined modality. PATIENTS AND MATERIALS: Patients receiving combined modality therapy with at least 2 or 3 cycles of chemotherapy prior to radiotherapy. Pre- and postchemotherapy cervical and thoracic CT scans are mandatory and should be performed, whenever possible, in the treatment position with the use of image fusion capabilities. A pre-chemotherapy PET scan is strongly recommended to increase the detection of involved lymph nodes. RESULTS: Radiation fields are designed to irradiate the initially involved lymph nodes exclusively and to encompass their initial volume. In some cases, radiation fields are slightly modified to avoid unnecessary irradiation of muscles or organs at risk. CONCLUSIONS: The concept of involved-node radiotherapy (INRT) described here is the first attempt to reduce the size of radiation fields compared to the classic involved fields used in adult patients. Proper implementation of INRT requires adequate training and an efficient prospective or early retrospective quality assurance program.

AB - BACKGROUND AND PURPOSE: To describe new concepts for radiation fields in patients with early stage Hodgkin lymphoma treated with a combined modality. PATIENTS AND MATERIALS: Patients receiving combined modality therapy with at least 2 or 3 cycles of chemotherapy prior to radiotherapy. Pre- and postchemotherapy cervical and thoracic CT scans are mandatory and should be performed, whenever possible, in the treatment position with the use of image fusion capabilities. A pre-chemotherapy PET scan is strongly recommended to increase the detection of involved lymph nodes. RESULTS: Radiation fields are designed to irradiate the initially involved lymph nodes exclusively and to encompass their initial volume. In some cases, radiation fields are slightly modified to avoid unnecessary irradiation of muscles or organs at risk. CONCLUSIONS: The concept of involved-node radiotherapy (INRT) described here is the first attempt to reduce the size of radiation fields compared to the classic involved fields used in adult patients. Proper implementation of INRT requires adequate training and an efficient prospective or early retrospective quality assurance program.

U2 - 10.1016/j.radonc.2006.05.015

DO - 10.1016/j.radonc.2006.05.015

M3 - Journal article

C2 - 16797755

SN - 0167-8140

VL - 79

SP - 270

EP - 277

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

IS - 3

ER -