- Volume 16 Issue 5
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Importance of PET/CT Scan Use in Planning Radiation Therapy for Lymphoma
- Milana, Mitric-Askovic (Institute of Oncology of Vojvodina, Sremska Kamenica) ;
- Marko, Erak (Institute of Oncology of Vojvodina, Sremska Kamenica) ;
- Miroslav, Latinovic (Institute of Oncology of Vojvodina, Sremska Kamenica) ;
- Tihomir, Dugandzija (Institute of Oncology of Vojvodina, Sremska Kamenica)
- Published : 2015.03.18
Background: Radiation therapy is a key part of the combined modality treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), which can achieve locoregional control of disease. The 3D-conformal radiation oncology can be extended-field (EFRT), involved-field (IFRT) and involved node (INRT). New techniques have resulted in a smaller radiation field and lower dose for critical organs such as lung heart and breast. Materials and Methods: In our research, we made a virtual simulation for one patient who was treated in four different radiotherapeutic techniques: mantle field (MFRT), EFRT, IFRT and INRT. After delineatiion we compared dose-volume histograms for each technique. The fusion of CT for planning radiotherapy with the initial PET/CT was made using Softver Xio 4.6 in the Focal program. The dose for all four techniques was 36Gy. Results: Our results support the use of PET/CT in radiation therapy planning. With IFRT and INRT, the burden on the organs at risk is less than with MFRT and EFRT. On the other hand, the dose distribution in the target volume is much better with the latter. Conclusions: The aim of modern radiotherapy of HL and NHL is to reduce the intensity of treatment and therefore PET/CT should be used to reduce and not increase the amount of tissue receiving radiation.
- Arnold CP, Bin S (2008). The PET-CT in Radiotherapy Treatment Planning. 1st ed. Philadelphia: Saunders, An Imprint of Elsevier.
- Barret A, Dobbs J, Morris S, Roques T (2009). Practical Radiotherapy Planning. 4th ed. London. Hodder Arnold.
- Beyzadeoglu M, Ozyigit G, Ebrul C (2010). Basic Radiation Oncology; Springer-Verlag Berlin Heidelberg.
- Eich HT, Staar S, Gossmann A, et al (2004). Centralized radiation oncologic review of cross-sectional imaging of Hodgkin's disease leads to significant changes in required involved field-results of a quality assurance program of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys, 58, 1121-7. https://doi.org/10.1016/j.ijrobp.2003.08.033
- Engert A, Schiller P, Josting A, et al (2003). Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavourable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol, 21, 3601-8. https://doi.org/10.1200/JCO.2003.03.023
- Girinskya T, Ghalibafian M, Bonniaud G, Bayla A, Magne N, et al. (2007).Is FDG-PET scan in patients with early stage Hodgkin lymphom aof any value in the implementation of the involved-node radiotherapy concept and dose painting? Radiotherapy Oncology, 85, 178-86. https://doi.org/10.1016/j.radonc.2007.07.003
- Girinskya T, Specht L, Ghalibafian M, et al (2008). The conundrum of hodgkin lymphoma nodes: To be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines. Radiotherapy Oncol, 88, 202-21. https://doi.org/10.1016/j.radonc.2008.05.012
- Girinskya T, Maazenb R, Spechtc L, et al (2006). Involvednode radiotherapy (INRT) in patients with early Hodgkin lymphoma: Concepts and guidelines. Radiotherapy Oncol, 79, 270-7. https://doi.org/10.1016/j.radonc.2006.05.015
- Ghalibafian M, Beaudre A, Girinsky T (2008). Heart and coronary artery protection in patients with mediastinal Hodgkin lymphoma treated with intensity-modulated radiotherapy: dose constraints to virtual volumes or to organs at risk? Radiother Oncol, 87, 82-8. https://doi.org/10.1016/j.radonc.2007.10.016
- Haioun C, Itti E, Rahmouni A, et al (2005).[18F]Fluoro-deoxy- Dglucose positron emission tomography (FDG-FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood, 106, 1376-81. https://doi.org/10.1182/blood-2005-01-0272
- Hasbek Z, Yucel B, Salk I, et al (2014). Potential impact of atelectasis and primary tumor glycolysis on F-18 FDG PET/ CT on survival in lung cancer patients. Asian Pac J Cancer Prev, 15, 4085-9. https://doi.org/10.7314/APJCP.2014.15.9.4085
- Hutchings M, Loft A, Hansen M, Berthelsen AK, Specht L (2007). Clinical impact of FDG-PET/CT in the planning of radiotherapy for early-stage Hodgkin lymphoma. Eur J Haematol, 78, 206-12. https://doi.org/10.1111/j.1600-0609.2006.00802.x
- Hutchings M, Eigvea I, Specht L (2004). FDG-PET in the clinical management of Hodgkin lymphoma. Crit Rev Oncol Hematol, 52, 19-32. https://doi.org/10.1016/j.critrevonc.2004.05.007
- IAEA (2008). The role of PET/CT in radiation treatment planning for cancer pantient treatment. Printed by the IAEA in Austria.
- Kang P, Seo W, Lee S, et al (2014). Incidental abnormal FDG uptake in the prostate on 18-fluoro-2-Deoxyglucose PET-CT scans. Asian Pac J Cancer Prev, 15, 8699-703. https://doi.org/10.7314/APJCP.2014.15.20.8699
- Kheng-Wei N, George M (2011). Role of radiotherapy in modern treatment of Hodgkin's lymphoma. Hindawi Publishing Corporation Advance in Hematology, publishing Corporation Advance in Hematology.
- Kostakoglu L, Coleman M, Leonard JP, et al (2002). PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin's disease. J Nucl Med, 43, 1018-27.
- Lee YK, Cook G, Flower MA, et al (2004). Addition of 18F-FDG-FDGPET scans to radiotherapy planning of thoracic lymphoma. Radiother Oncol, 73, 277-83. https://doi.org/10.1016/j.radonc.2004.07.029
- Mikhaeel NG, Hutchings M, Fields PA, et al (2005). FDGPET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non- Hodgkin lymphoma. Ann Oncol, 16, 1514-23. https://doi.org/10.1093/annonc/mdi272
- NCCN Clinical Practice Guidelines in Oncology V.2.2010. www.nccn.org.
- Nieder C, Schill S, Kneschaurek P, Molls M (2007). Comparison of three different mediastinal radiotherapy techniques in female patients: impact on heart sparing and dose to the breasts. Radiother Oncol, 82, 301-7. https://doi.org/10.1016/j.radonc.2006.10.015
- Paulino AC, Margolin J, Dreyer Z, Bin S, Teh SC (2001). Impact of PET-CT on involved field radiotherapy design for pediatric Hodgkin lymphoma. Pediatric Blood & Cancer, 58, 860-4.
- Phungrassami T, Funsian A, Spirlung H, (2013). 30 Years of radiotherapy service in Southern Thailand: workload vs resources. Asian Pac J Cancer Prev, 14, 7743-8. https://doi.org/10.7314/APJCP.2013.14.12.7743
- Schinagl DA, Hoffmann AL, Voge VW, et al (2009). Can FDG-PET assist in radiotherapy target volume definition of metastatic lymph nodes in head and nech cancer? Radiother Oncol, 91, 95-100. https://doi.org/10.1016/j.radonc.2009.02.007
- Spaepenk K, Stroobants S, Verhoef G, et al (2003). Positron emission tomography with [(18)F]FDG for therapy response monitoring in lymphoma patients. Eur J Nucl Med Mol Imaging, 30, 97-105. https://doi.org/10.1007/s00259-003-1166-5
- Specht L, Yahalom J (2011). Radiotherapy for Hodgkin Lymphoma. Springer-Verlag Berlin Heidelberg.