Thyroid V30 Predicts Radiation-Induced Hypothyroidism in Patients Treated With Sequential Chemo-Radiotherapy for Hodgkin’s Lymphoma

2012 ◽  
Vol 82 (5) ◽  
pp. 1802-1808 ◽  
Author(s):  
Laura Cella ◽  
Manuel Conson ◽  
Michele Caterino ◽  
Nicola De Rosa ◽  
Raffaele Liuzzi ◽  
...  
2012 ◽  
Vol 39 (6Part30) ◽  
pp. 3994-3994
Author(s):  
A Toltz ◽  
N Shin ◽  
C Laude ◽  
D Roberge ◽  
C Freeman ◽  
...  

Author(s):  
Niklas Benedikt Pepper ◽  
Michael Oertel ◽  
Christopher Kittel ◽  
Kai Jannes Kröger ◽  
Khaled Elsayad ◽  
...  

Abstract Purpose Mediastinal radiotherapy (RT), especially when combined with bleomycin, may result in substantial pulmonary morbidity and mortality. The use of modern RT techniques like intensity-modulated radiotherapy (IMRT) is gaining interest to spare organs at risk. Methods We evaluated 27 patients who underwent RT for Hodgkin’s lymphoma between 2009 and 2013 at our institution. For each patient, three different treatment plans for a 30-Gy involved-field RT (IFRT) were created (anterior-posterior-posterior-anterior setup [APPA], 5‑field IMRT, and 7‑field IMRT) and analyzed concerning their inherent “normal tissue complication probability” (NTCP) for pneumonitis and secondary pulmonary malignancy. Results The comparison of different radiation techniques showed a significant difference in favor of standard APPA (p < 0.01). The risk of lung toxicity was significantly higher in plans using 7‑field IMRT than in plans using 5‑field IMRT. The absolute juxtaposition showed an increase in risk for radiation pneumonitis of 1% for plans using 5‑field IMRT over APPA according to QUANTEC (Quantitative Analyses of Normal Tissue Effects in the Clinic) parameters (Burman: 0.15%) and 2.6% when using 7‑field IMRT over APPA (Burman: 0.7%) as well as 1.6% when using 7‑field IMRT over 5‑field IMRT (Burman: 0.6%). Further analysis showed an increase in risk for secondary pulmonary malignancies to be statistically significant (p < 0.01); mean induction probability for pulmonary malignoma was 0.1% higher in plans using 5‑field IMRT than APPA and 0.19% higher in plans using 7‑field IMRT than APPA as well as 0.09% higher in plans using 7‑field IMRT than 5‑field IMRT. During a median follow-up period of 65 months (95% confidence interval: 53.8–76.2 months), only one patient developed radiation-induced pneumonitis. No secondary pulmonary malignancies have been detected to date. Conclusion Radiation-induced lung toxicity is rare after treatment for Hodgkin lymphoma but may be influenced significantly by the RT technique used. In this study, APPA RT plans demonstrated a decrease in potential radiation pneumonitis and pulmonary malignancies. Biological planning using NTCP may have the potential to define personalized RT strategies


Blood ◽  
1989 ◽  
Vol 73 (6) ◽  
pp. 1677-1681
Author(s):  
F Casamassima ◽  
C Ruggiero ◽  
D Caramella ◽  
E Tinacci ◽  
N Villari ◽  
...  

Magnetic resonance imaging (MRI) is able to detect the increase of adipocytes in the hematopoietic bone marrow that occurs as a consequence of radiotherapy and is indicative of the loss of myeloid tissue. By monitoring this process, it is also possible to determine the recovery of the bone marrow. The amount of viable hematopoietic tissue plays a fundamental role in determining whether the patient is able to undergo further antineoplastic therapy, particularly chemotherapy. We examined 35 patients who had been treated with radiotherapy for Hodgkin's lymphoma (12), uterine cervix carcinoma (nine), ovarian dysgerminoma (six), testicular seminoma (four), and non- Hodgkin's lymphoma (four). We observed that radiation-induced modifications of the MRI pattern in the bone marrow are tightly linked to two parameters; the administered radiation dose and the length of time passed after the treatment. Bone marrow recovery was observed only when patients were treated with doses lower than 50 Gy. The earlier radiation-induced modifications of the bone marrow MRI pattern occurred 6 to 12 months after irradiation, and they were most evident 5 to 6 years after the treatment. From 2 to 9 years after radiotherapy, we observed partial recovery. Complete recovery, when it occurred, was observed only 10 to 23 years after the treatment. Our results indicate that MRI studies are likely to be useful in the assessment of radiation- induced injuries.


2020 ◽  
Author(s):  
Yaser Khalid ◽  
Michael Fradley ◽  
Neethi Dasu ◽  
Kirti Dasu ◽  
Ankit Shah ◽  
...  

Abstract Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there has been very little investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. PubMed, google scholar, and Cochrane databases were searched to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.


2020 ◽  
Author(s):  
Yaser Khalid ◽  
Michael Fradley ◽  
Neethi Dasu ◽  
Kirti Dasu ◽  
Ankit Shah ◽  
...  

Abstract Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there is minimal investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. OVID, Cochrane Central Register of Controlled Trials via the Wiley Interface, Web of Science Core Collection, MEDLINE, EMBASE, and Google Scholar were investigated to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.


2018 ◽  
Vol 127 ◽  
pp. S373-S374
Author(s):  
S. Appel ◽  
Y.R. Lawrence ◽  
Z. Symon ◽  
E. Landau ◽  
M. Ben-David

Blood ◽  
1989 ◽  
Vol 73 (6) ◽  
pp. 1677-1681 ◽  
Author(s):  
F Casamassima ◽  
C Ruggiero ◽  
D Caramella ◽  
E Tinacci ◽  
N Villari ◽  
...  

Abstract Magnetic resonance imaging (MRI) is able to detect the increase of adipocytes in the hematopoietic bone marrow that occurs as a consequence of radiotherapy and is indicative of the loss of myeloid tissue. By monitoring this process, it is also possible to determine the recovery of the bone marrow. The amount of viable hematopoietic tissue plays a fundamental role in determining whether the patient is able to undergo further antineoplastic therapy, particularly chemotherapy. We examined 35 patients who had been treated with radiotherapy for Hodgkin's lymphoma (12), uterine cervix carcinoma (nine), ovarian dysgerminoma (six), testicular seminoma (four), and non- Hodgkin's lymphoma (four). We observed that radiation-induced modifications of the MRI pattern in the bone marrow are tightly linked to two parameters; the administered radiation dose and the length of time passed after the treatment. Bone marrow recovery was observed only when patients were treated with doses lower than 50 Gy. The earlier radiation-induced modifications of the bone marrow MRI pattern occurred 6 to 12 months after irradiation, and they were most evident 5 to 6 years after the treatment. From 2 to 9 years after radiotherapy, we observed partial recovery. Complete recovery, when it occurred, was observed only 10 to 23 years after the treatment. Our results indicate that MRI studies are likely to be useful in the assessment of radiation- induced injuries.


2018 ◽  
Vol 13 (15) ◽  
pp. e1771-e1773 ◽  
Author(s):  
Elise Paven ◽  
Claire Cimadevilla ◽  
Marina Urena ◽  
Marie-Pierre Dilly ◽  
Patrick Nataf ◽  
...  

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