Modern PET-Guided Radiotherapy Planning and Treatment for Malignant Lymphoma

Pepper, Niklas Benedikt; Oertel, Michael; Rehn, Stephan; Kobe, Carsten; Eich, Hans Theodor

doi:10.1053/j.semnuclmed.2022.09.001

Cited by 8 publications

(2 citation statements)

References 52 publications

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“…Modern treatment volume concepts rely on PET scans fused with planning CT scans or scans performed in the treatment position. ISRT is now the international standard of care, and implementing these concepts in clinical practice remains challenging and requires PET/CT imaging for interpreting and defining treatment volumes [18].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Residual Site Radiation Therapy (ISRT) in Patients with Primary Mediastinal Lymphoma with Deauville Score 4 Following R-CHT: Results of a Retrospective Mono Institutional Study

Facondo

Serio

Vullo

et al. 2023

JCM

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Background: In order to evaluate the efficacy of residual site radiation therapy (RSRT) in terms of progression-free survival (PFS) and overall survival (OS) in patients with primary mediastinal lymphoma (PMBCL) with Deauville Score 4 (DS 4) following rituximab and chemotherapy treatment (R-ICHT). Methods: Thirty-one patients with PMBCL were recruited. After completion of R-ICHT, patients were staged with 18F-fluorodeoxyglucose positron-emission tomography, showing DS 4, and were treated with adjuvant RSRT. The chosen techniques for RT delivery were intensity-modulated radiation therapy (IMRT) or three-dimensional conformal RT (3D-CRT). Most patients underwent the first one using cone-beam computed tomography (CBCT). All patients were evaluated every 3 months for the first 2 years and every 6 months afterwards for a period of at least 5 years, with clinical and radiological procedures as required. Results: All patients received RSRT with a dose of 30 Gy in 15 fractions. The median follow-up time of 52.7 months (IQR: 26–64.1 months). The 5-year OS rate was 100%. The 2-year and 5-year PFS rates were 96.7% and 92.5%, respectively. Patients with relapsed disease had been treated with high-dose chemotherapy (HDC) and autologous stem cell transplantation (auto-SCT). Conclusion: RSRT in patients with PMBCL treated with ICHT and DS 4 did not impact unfavorably on patient survival.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Residual Site Radiation Therapy (ISRT) in Patients with Primary Mediastinal Lymphoma with Deauville Score 4 Following R-CHT: Results of a Retrospective Mono Institutional Study

Facondo

Serio

Vullo

et al. 2023

JCM

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“…The creation of these volumes relies heavily on FDG-PET/CT-imaging for lymphoma treatment. Metabolic imaging has not only demonstrated high value in diagnosis and response assessment [23][24][25], but is now the basis for RT planning in most lymphoma entities [20,[26][27][28] even though some limitations remain [21,29]. Uncertainties in image interpretation can be a concern and should be discussed in an interdisciplinary setting since they may require additional extension of safety margins based on clinical judgment [3][4][5]21].…”

Section: Target Volume Definition For Isrt (Summary Of Ilrog Guidelines)mentioning

confidence: 99%

Evolution of Radiation Fields from Involved Field to Involved Site—A Summary of the Current Guidelines by the International Lymphoma Radiation Oncology Group

Eich,

Pepper,

Oertel

2023

Lymphatics

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Radiation therapy has been proven to be highly effective in the treatment of lymphoma. With increasing rates of long-term survival, the reduction in toxicity has gained importance. The evolving understanding of the diseases’ biology, as well as technical and conceptual advances, allows for a precise and individualized application of irradiation. Smaller treatment fields and safety margins make it possible to spare healthy neighbouring tissue (organs at risk). The International Lymphoma Radiation Oncology Group (ILROG) has developed several guidelines to optimize radiotherapy treatment in lymphoma patients. Since its introduction in 2013, involved site radiotherapy (ISRT) has been adopted as the standard of care in most treatment regimens in adult lymphoma. This article serves as a summary of the current ILROG guidelines, also considering contemporary developments and possible future directions.

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In Regard to Campbell et al.

Oertel¹,

Eich²

2023

International Journal of Radiation Oncology*Biology*Physics

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Modern PET-Guided Radiotherapy Planning and Treatment for Malignant Lymphoma

Cited by 8 publications

References 52 publications

Efficacy of Residual Site Radiation Therapy (ISRT) in Patients with Primary Mediastinal Lymphoma with Deauville Score 4 Following R-CHT: Results of a Retrospective Mono Institutional Study

Efficacy of Residual Site Radiation Therapy (ISRT) in Patients with Primary Mediastinal Lymphoma with Deauville Score 4 Following R-CHT: Results of a Retrospective Mono Institutional Study

Evolution of Radiation Fields from Involved Field to Involved Site—A Summary of the Current Guidelines by the International Lymphoma Radiation Oncology Group

In Regard to Campbell et al.

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