News | March 04, 2015

New Dose Guidelines Issued for Pediatric Hodgkin Lymphoma Treatment

Use of FDG-PET imaging could reduce dose 65 to 80 percent

Hodgkin lymphoma, pediatric imaging, guidelines, radiation therapy, FDG-PET, CT

March 4, 2015 — The International Lymphoma Radiation Oncology Group (ILROG) has issued a guideline outlining the use of 3-D computed tomography (CT)-based radiation therapy planning and volumetric image guidance for treatment of pediatric Hodgkin lymphoma. The goal of the new guideline is to reduce the radiation dose to normal tissue, thus decreasing the risk of late side effects. The guideline will be published in the March-April issue of Practical Radiation Oncology (PRO), the clinical practice journal of the American Society for Radiation Oncology (ASTRO).

Historically, pediatric Hodgkin lymphoma patients were treated with the same chemotherapy and radiation regimens as adults, which potentially exposes their young, still-growing bodies to more treatment than necessary. Previous radiation therapy guidelines for pediatric Hodgkin lymphoma have focused on 2-D imaging and bony landmarks to define dose volumes for radiation therapy treatment, and treated large volumes of normal tissue in part because of uncertainty about which lymph node areas were involved.  

The new guideline describes how to effectively use modern imaging and innovations in radiation therapy planning technology to treat patients with pediatric Hodgkin lymphoma while decreasing the risk of late side effects, including second cancers and heart disease.

The authors describe methods for identifying target volumes for radiation therapy, and how to implement the concept of “involved site radiation therapy” to define radiation target volumes and limit dose to normal organs at risk. According to the guideline, accurate assessment of the extent and location of disease requires both contrast-enhanced CT as well as fluorodeoxyglucose-positron emission tomography (FDG-PET). The document describes how the evaluation of response to chemotherapy influences the targeting of the lymphoma and the volume of normal tissue treated, by using recently developed capacity to fuse CT and FDG-PET images taken before and after chemotherapy to CT imaging taken for radiation therapy planning.

“The emergence of new imaging technologies, more accurate ways of delivering radiation therapy and more detailed patient selection criteria have made a significant change in our ability to customize treatment for many cancer patients,” said David C. Hodgson, M.D., associate professor in the Department of Radiation Oncology at the University of Toronto in Toronto, a radiation oncologist at Princess Margaret Hospital/University Health Network in Toronto and lead author of the guideline. “This guideline has the potential to reduce the radiation therapy breast dose by about 80 percent and the heart dose by about 65 percent for an adolescent girl with Hodgkin lymphoma. This shift in more personalized treatment planning tailored to the individual patient’s disease will optimize risk-benefit considerations for our patients, and reduce the likelihood that they will suffer late effects from radiation therapy. We are also excited that these guidelines will be utilized in an upcoming Children’s Oncology Group Study of involved-site radiation therapy for high-risk Hodgkin lymphoma patients and eagerly await the study’s results.”

For more information: www.astro.org

Related Content

MedStar Georgetown Proton Center Selects RayStation for Treatment Planning
News | Treatment Planning | August 17, 2017
August 17, 2017 — The proton center at MedStar Georgetown University Hospital will utilize RayStation for planning on
Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
DOSIsoft Releases ISOgray Proton Therapy Treatment Planning System
Technology | Treatment Planning | August 15, 2017
DOSIsoft SA announced the official release, with CE marking, of ISOgray Treatment Planning System (TPS) release 4.3 for...
RSNA Announces Pediatric Bone Age Machine Learning Challenge
News | Artificial Intelligence | August 10, 2017
August 10, 2017 — The Radiological Society of North America (RSNA) is organizing a challenge intended to show the app
First Radixact Results Presented at AAPM 2017
News | Radiation Therapy | August 10, 2017
Accuray Inc. announced that the first studies validating the benefits of the Radixact System were presented at the 59th...
Four Blue Cross Blue Shield Companies Issue Positive Medical Policies on HeartFlow FFRct Analysis
News | Computed Tomography (CT) | August 09, 2017
HeartFlow Inc. announced that four Blue Cross Blue Shield companies have each issued a positive medical policy for the...
Clinical Data Supports Use of Xoft System for Endometrial Cancer
News | Brachytherapy Systems | August 03, 2017
Researchers presented clinical data supporting use of the Xoft Axxent Electronic Brachytherapy (eBx) System for the...
Aktina’s interchangeable cones are lightweight and extremely accurate
News | Radiation Therapy | August 02, 2017
Aktina Medical announced a collaboration with Philips Medical Systems and Elekta Instruments for SRS interlocking at...
The American Lung Association created LUNG FORCE, a national movement to defeat lung cancer
News | Lung Cancer | August 02, 2017
To raise public awareness of lung cancer—the leading cancer killer of men and women—the American Lung Association's...
Overlay Init