Reviewing of radical radiotherapy to the mediastinum in patients with lymphoma

Zeina Abd-Aljabbar Mahdi Jaber, Baghdad Radiation Oncology and Nuclear Medicine Hospital, Baghdad Medical City, Baghdad, Iraq.Follow
Manwar Al-Naqqash, Department of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq.Follow

Article Type

Original Study

Abstract

Background: Historically and clinically, lymphomas are categorized into two major groups: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Over the years, radiotherapy techniques have advanced from extended-field to involved-field and more recently to involved-site/involved node radiation therapy (RT) (ISRT/INRT). Aim: This study aimed to evaluate the efficacy of mediastinal radiotherapy in lymphoma patients in Iraq. Methods: A prospective study was conducted to assess clinical and dosimetric changes in various radiotherapy planes and dosimetry between January 2023 and December 2023. The data collected included The data collected included patient demographics, medical history, treatment details, lymphoma characteristics, staging, radiotherapy plans, dose/fraction, and organ doses. Results: The study included 30 lymphoma patients (19 HL and 11 NHL cases) with a mean age of 31.3 ± 9.11 years. The non-coplanar group demonstrated superior mean PTV coverage compared to the coplanar volumetric modulated arc therapy (VMAT) group (P = 0.005). Additionally, the mean heart dose in the coplanar plans was greater than that in the non-coplanar arm (p < 0.0001). The coplanar plans also showed higher mean doses to the left lung at V20 in comparison to the non-coplanar plans (p = 0.007). Furthermore, the mean dose to the spinal cord in the coplanar VMAT group was greater than that in the non-coplanar group (p = 0.003). The median survival times were 11 months for HL and 12 months for NHL. Patients treated with coplanar plans had a median survival of 10.36 months, while those treated with non-coplanar plans had a median survival of 8.13 months. The recurrence rate was 23.3%, with a 3.3% risk of cardiac toxicity. Conclusions: The mean PTV coverage in the non-coplanar group surpassed that of the coplanar VMAT group. The median survival for HL patients was less than that for NHL patients within the same follow-up period. The survival rate of patients under coplanar plans exceeded that of patients under non-coplanar plans.

Keywords

lymphoma, diffuse large B-cell lymphoma, median survival, non-Hodgkin lymphoma

Recommended Citation

Abd-Aljabbar Mahdi Jaber, Zeina and Al-Naqqash, Manwar (2025) "Reviewing of radical radiotherapy to the mediastinum in patients with lymphoma," Iraqi National Journal of Medicine: Vol. 7 : Iss. 2 , Article 18.
Available at: https://doi.org/10.37319/