Purpose: Hodgkin lymphoma is a hematologic malignancy with excellent outcomes even in advanced stages. Consequently, the importance of treatment-associated toxicity increases. However, the exact estimation of individualized rates is difficult due to different disease extents, treatment strategies and techniques. The following analysis aims at a pre-treatment estimation of relevant mediastinal toxicities. Methods: Normal tissue complication probability calculations were used to evaluate the toxicity rates for the heart, lungs and female breast of patients undergoing radiotherapy for early-stage Hodgkin lymphoma. Overall, 45 Patients of the HD16 and HD17 trials by the German Hodgkin study group were included and risks were calculated using the Lyman–Kutcher–Burman model. Results: The median values for pericarditis, pneumonitis and fibrosis of the left or right breast were 0.0%, 0.0%, 0.7% and 0.6% in the HD16 cohort, and 0.0%, 0.1%, 1.1% and 1.0% in the HD17 cohort, respectively. Correspondingly, none of the included patients displayed any of the evaluated toxicities during clinical follow-up. The use of higher doses (30 Gy) in the HD17 cohort led to an increase in toxicity compared to the HD16 cohort (20 Gy). No significant influence of the planning target volume size or the radiation technique could be found in this study. Conclusion: Both the clinically observed and calculated toxicity rates corroborate the overall low-risk profile of radiotherapy for Hodgkin lymphoma. Further treatment individualization will be attempted in the future.
目的：霍奇金淋巴瘤是一种血液系统恶性肿瘤，即使在晚期阶段也具有良好预后。因此，治疗相关毒性的重要性日益凸显。然而，由于疾病范围、治疗策略和技术的差异，个体化毒性发生率的精确评估较为困难。本研究旨在对相关纵隔毒性进行放疗前预测评估。 方法：采用正常组织并发症概率计算方法，评估早期霍奇金淋巴瘤患者接受放疗时心脏、肺及女性乳腺的毒性发生率。研究纳入德国霍奇金研究组HD16和HD17试验的45例患者，运用Lyman-Kutcher-Burman模型进行风险计算。 结果：在HD16队列中，心包炎、肺炎及左右乳腺纤维化的中位发生率分别为0.0%、0.0%、0.7%和0.6%；HD17队列中相应数值分别为0.0%、0.1%、1.1%和1.0%。临床随访期间，所有入组患者均未出现上述评估的毒性反应。与HD16队列（20 Gy）相比，HD17队列采用更高剂量（30 Gy）导致毒性发生率有所上升。本研究未发现计划靶区大小或放疗技术对毒性发生率有显著影响。 结论：临床观察与计算所得的毒性发生率均证实霍奇金淋巴瘤放疗具有总体低风险特征。未来将进一步探索治疗方案的个体化优化。
肿瘤(癌症)患者之家