ArticleRadiation oncology (London, England)2014
Dosimetric advantages of a "butterfly" technique for intensity-modulated radiation therapy for young female patients with mediastinal Hodgkin's lymphoma.
Article in Radiation oncology (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 107 citations in OpenAlex.
- Hodgkin lymphoma, version 2.2015.Journal of the National Comprehensive Cancer Network : JNCCN · 2015Guideline
- Subsequent Neoplasm Risk After Modern Mediastinal Radiation Therapy for Pediatric Hodgkin Lymphoma: Insights From a Multi-Institutional Children's Oncology Group Trial.International journal of radiation oncology, biology, physics · 2026Article
- Comparing Organs at Risk Sparing Between Intensity-Modulated Radiotherapy and Pencil-Beam Scanning Plans Based on Disease Location for Hodgkin and Non-Hodgkin Lymphoma.International journal of particle therapy · 2026Article
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- Beyond surgery: the proper role and delivery of radiation therapy in the local-regional management of BIA-ALCL.Case reports in plastic surgery & hand surgery · 2024Article
- Predicted cardiac and second cancer risks for patients undergoing VMAT for mediastinal Hodgkin lymphoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023Article
- Second malignancies in patients with Hodgkin's Lymphoma: Half a century of experience.Clinical and translational radiation oncology · 2022Article
- Introduction of deep inspirational breath-hold and Butterfly-VMAT techniques into clinical practice for the treatment of mediastinal lymphoma - Lessons learned from an experienced centre.Technical innovations & patient support in radiation oncology · 2022Article
- Proton Therapy in Supradiaphragmatic Lymphoma: Predicting Treatment-Related Mortality to Help Optimize Patient Selection.International journal of radiation oncology, biology, physics · 2022Article
- Harnessing benefit of highly conformal RT techniques for lymphoma patients.The British journal of radiology · 2021Review
- The role of motion management and position verification in lymphoma radiotherapy.The British journal of radiology · 2021Review
- Past, Present, and Future of Radiation-Induced Cardiotoxicity: Refinements in Targeting, Surveillance, and Risk Stratification.JACC. CardioOncology · 2021 · on this mapReview
- Current Situation of Proton Therapy for Hodgkin Lymphoma: From Expectations to Evidence.Cancers · 2021Review
- Deep inspiration breath hold versus free breathing technique in mediastinal radiotherapy for lymphoma.BJR open · 2021Article
- On the Importance of Individualized, Non-Coplanar Beam Configurations in Mediastinal Lymphoma Radiotherapy, Optimized With Automated Planning.Frontiers in oncology · 2021Article
- Assessment of Radiation Doses Delivered to Organs at Risk Among Patients With Early-Stage Favorable Hodgkin Lymphoma Treated With Contemporary Radiation Therapy.JAMA network open · 2020Article
- Biological optimization for mediastinal lymphoma radiotherapy - a preliminary study.Acta oncologica (Stockholm, Sweden) · 2020Article
- Fondazione Italiana Linfomi (FIL) expert consensus on the use of intensity-modulated and image-guided radiotherapy for Hodgkin's lymphoma involving the mediastinum.Radiation oncology (London, England) · 2020Review
- Secondary Malignancy Risk Following Proton vs. X-ray Treatment of Mediastinal Malignant Lymphoma: A Comparative Modeling Study of Thoracic Organ-Specific Cancer Risk.Frontiers in oncology · 2020Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeHigh cure rates for Hodgkin's lymphoma must be balanced with long-term treatment-related toxicity. Here we report an intensity-modulated radiation therapy (IMRT) technique that achieves adequate target coverage for mediastinal disease while minimizing high- and low-dose exposure of critical organs. METHODS AND MATERIALS: Treatment plans for IMRT and conventional anteroposterior-posteroanterior (AP-PA) techniques, with comparable coverage of the planning target volume (PTV), were generated for 9 female patients with mediastinal Hodgkin's lymphoma assuming use of inclined positioning, daily breath-hold, and CT-on-rails verification. Our "butterfly" IMRT beam arrangement involved anterior beams of 300°-30° and posterior beams of 160°-210°. Percentages of normal structures receiving 30 Gy (V30), 20 Gy (V20), and 5 Gy (V5) were tabulated for the right and left breasts, total lung, heart, left and right ventricles, left anterior descending coronary artery (LAD), and spinal cord. Differences in each variable, conformity index, homogeneity index, and V107% between the two techniques were calculated (IMRT minus conventional).
resultsUse of IMRT generally reduced the V30 and V20 to critical structures: -1.4% and +0.1% to the right breast, -1.7% and -0.9% to the left breast, -14.6% and -7.7% to the total lung, -12.2% and -10.5% to the heart, -2.4% and -14.2% to the left ventricle, -16.4% and -8.4% to the right ventricle, -7.0% and -14.2% to the LAD, and -52.2% and -13.4% to the spinal cord. Differences in V5 were +6.2% for right breast, +2.8% for left breast, +12.9% for total lung, -3.5% for heart, -8.2% for left ventricle, -1.5% for right ventricle, +0.1% for LAD, and -0.1% for spinal cord. Use of IMRT significantly reduced the volume of tissue receiving 107% of the dose (mean 754 cm3 reduction).
conclusionsThis butterfly technique for IMRT avoids excess exposure of heart, breast, lung, and spinal cord to doses of 30 or 20 Gy; mildly increases V5 to the breasts; and decreases the V107%.
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