Percussion assisted radiation therapy in Hodgkin lymphoma allows a marked reduction in heart dose

Radiother Oncol. 2020 Nov;152:163-168. doi: 10.1016/j.radonc.2019.11.009. Epub 2020 May 21.

Abstract

Background and purpose: Early-stage Hodgkin lymphoma (HL) is a highly curable disease but the treatment can induce late complications many years later. Irradiation of the healthy heart is inevitable during radiation treatment of mediastinal sites. We developed a novel method to induce a prolonged apnea-like state that can help decrease the dose to organs at risk during radiation therapy. We present the results of the first 8 HL patients treated routinely with percussion assisted radiation therapy (PART) in our clinic.

Material and methods: We used a newly developed high-frequency non-invasive ventilation system to suppress respiratory motion for prolonged periods and push the heart away from the treated volume.

Results: All 8 patients were able to rapidly learn the technique and had an advantage to be treated by PART. We lowered the mean heart dose by an average of 3 Gy with similar target coverage compared to a classical free breathing treatment plan. They were all treated for 15 radiotherapy sessions by PART without any notable side effects.

Conclusions: Percussion assisted radiation therapy can be used routinely to reduce the dose to the heart in Hodgkin lymphoma.

Keywords: Hodgkin disease; Radiotherapy; Respiratory motion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Heart
  • Hodgkin Disease* / radiotherapy
  • Humans
  • Organs at Risk
  • Percussion
  • Radiation Injuries* / etiology
  • Radiation Injuries* / prevention & control
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Intensity-Modulated*