Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy

Chelsea C. Pinnix; Andrew Wirth; Sarah A. Milgrom; Therese Y. Andraos; Michalis Aristophanous; Mary Pham; Donald Hancock; Ethan B. Ludmir; Jillian R. Gunther; Michelle A. Fanale; Yasuhiro Oki; Loretta Nastoupil; Hubert H. Chuang; N. George Mikhaeel; Bouthaina S. Dabaja

doi:10.1080/10428194.2018.1452211

Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy

Chelsea C. Pinnix, Andrew Wirth, Sarah A. Milgrom, Therese Y. Andraos, Michalis Aristophanous, Mary Pham, Donald Hancock, Ethan B. Ludmir, Jillian R. Gunther, Michelle A. Fanale, Yasuhiro Oki, Loretta Nastoupil, Hubert H. Chuang, N. George Mikhaeel, Bouthaina S. Dabaja

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Cardiophrenic lymph nodes (CPLNs) are occasionally involved in Hodgkin lymphoma (HL). We characterized the incidence of CPLN involvement among 169 HL patients and evaluated outcomes after treatment with omission of the CPLN region from the involved-site radiation therapy (ISRT) field. Three types of RT fields were used: standard (S)-ISRT, reduced-dose (RD)-ISRT (lower dose to CPLNs, standard to other sites), or modified (M)-ISRT (omission of CPLNs). CPLNs were involved at diagnosis in 29 patients (17%). Of the 20 patients who received RT after complete response to chemotherapy, 4(20%) received S-ISRT, 8(40%) RD-ISRT, and 8(40%) M-ISRT. The four-year progression-free survival was 94.7%. One relapse occurred at a non-CPLN site after RD-ISRT. The mean heart dose and volume of the heart that received 25 Gy was higher for S-ISRT patients compared to M-ISRT (p =.043 and p =.025, respectively). Re-planning the M-ISRT cases as S-ISRT resulted in significant increase in cardiac doses.

Original language	English (US)
Pages (from-to)	2650-2659
Number of pages	10
Journal	Leukemia and Lymphoma
Volume	59
Issue number	11
DOIs	https://doi.org/10.1080/10428194.2018.1452211
State	Published - Nov 2 2018

Keywords

Hodgkin lymphoma
cardiophrenic lymph nodes
radiation therapy

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

Access to Document

10.1080/10428194.2018.1452211

Cite this

Pinnix, C. C., Wirth, A., Milgrom, S. A., Andraos, T. Y., Aristophanous, M., Pham, M., Hancock, D., Ludmir, E. B., Gunther, J. R., Fanale, M. A., Oki, Y., Nastoupil, L., Chuang, H. H., Mikhaeel, N. G., & Dabaja, B. S. (2018). Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy. Leukemia and Lymphoma, 59(11), 2650-2659. https://doi.org/10.1080/10428194.2018.1452211

Pinnix, CC, Wirth, A, Milgrom, SA, Andraos, TY, Aristophanous, M, Pham, M, Hancock, D, Ludmir, EB , Gunther, JR, Fanale, MA, Oki, Y, Nastoupil, L , Chuang, HH, Mikhaeel, NG & Dabaja, BS 2018, 'Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy', Leukemia and Lymphoma, vol. 59, no. 11, pp. 2650-2659. https://doi.org/10.1080/10428194.2018.1452211

@article{12f5339dd0e643cbafafc8ebc31a6818,

title = "Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy",

abstract = "Cardiophrenic lymph nodes (CPLNs) are occasionally involved in Hodgkin lymphoma (HL). We characterized the incidence of CPLN involvement among 169 HL patients and evaluated outcomes after treatment with omission of the CPLN region from the involved-site radiation therapy (ISRT) field. Three types of RT fields were used: standard (S)-ISRT, reduced-dose (RD)-ISRT (lower dose to CPLNs, standard to other sites), or modified (M)-ISRT (omission of CPLNs). CPLNs were involved at diagnosis in 29 patients (17%). Of the 20 patients who received RT after complete response to chemotherapy, 4(20%) received S-ISRT, 8(40%) RD-ISRT, and 8(40%) M-ISRT. The four-year progression-free survival was 94.7%. One relapse occurred at a non-CPLN site after RD-ISRT. The mean heart dose and volume of the heart that received 25 Gy was higher for S-ISRT patients compared to M-ISRT (p =.043 and p =.025, respectively). Re-planning the M-ISRT cases as S-ISRT resulted in significant increase in cardiac doses.",

keywords = "Hodgkin lymphoma, cardiophrenic lymph nodes, radiation therapy",

author = "Pinnix, {Chelsea C.} and Andrew Wirth and Milgrom, {Sarah A.} and Andraos, {Therese Y.} and Michalis Aristophanous and Mary Pham and Donald Hancock and Ludmir, {Ethan B.} and Gunther, {Jillian R.} and Fanale, {Michelle A.} and Yasuhiro Oki and Loretta Nastoupil and Chuang, {Hubert H.} and Mikhaeel, {N. George} and Dabaja, {Bouthaina S.}",

note = "Publisher Copyright: {\textcopyright} 2018, {\textcopyright} 2018 Informa UK Limited, trading as Taylor & Francis Group.",

year = "2018",

month = nov,

day = "2",

doi = "10.1080/10428194.2018.1452211",

language = "English (US)",

volume = "59",

pages = "2650--2659",

journal = "Leukemia and Lymphoma",

issn = "1042-8194",

publisher = "Informa Healthcare",

number = "11",

}

TY - JOUR

T1 - Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy

AU - Pinnix, Chelsea C.

AU - Wirth, Andrew

AU - Milgrom, Sarah A.

AU - Andraos, Therese Y.

AU - Aristophanous, Michalis

AU - Pham, Mary

AU - Hancock, Donald

AU - Ludmir, Ethan B.

AU - Gunther, Jillian R.

AU - Fanale, Michelle A.

AU - Oki, Yasuhiro

AU - Nastoupil, Loretta

AU - Chuang, Hubert H.

AU - Mikhaeel, N. George

AU - Dabaja, Bouthaina S.

PY - 2018/11/2

Y1 - 2018/11/2

N2 - Cardiophrenic lymph nodes (CPLNs) are occasionally involved in Hodgkin lymphoma (HL). We characterized the incidence of CPLN involvement among 169 HL patients and evaluated outcomes after treatment with omission of the CPLN region from the involved-site radiation therapy (ISRT) field. Three types of RT fields were used: standard (S)-ISRT, reduced-dose (RD)-ISRT (lower dose to CPLNs, standard to other sites), or modified (M)-ISRT (omission of CPLNs). CPLNs were involved at diagnosis in 29 patients (17%). Of the 20 patients who received RT after complete response to chemotherapy, 4(20%) received S-ISRT, 8(40%) RD-ISRT, and 8(40%) M-ISRT. The four-year progression-free survival was 94.7%. One relapse occurred at a non-CPLN site after RD-ISRT. The mean heart dose and volume of the heart that received 25 Gy was higher for S-ISRT patients compared to M-ISRT (p =.043 and p =.025, respectively). Re-planning the M-ISRT cases as S-ISRT resulted in significant increase in cardiac doses.

AB - Cardiophrenic lymph nodes (CPLNs) are occasionally involved in Hodgkin lymphoma (HL). We characterized the incidence of CPLN involvement among 169 HL patients and evaluated outcomes after treatment with omission of the CPLN region from the involved-site radiation therapy (ISRT) field. Three types of RT fields were used: standard (S)-ISRT, reduced-dose (RD)-ISRT (lower dose to CPLNs, standard to other sites), or modified (M)-ISRT (omission of CPLNs). CPLNs were involved at diagnosis in 29 patients (17%). Of the 20 patients who received RT after complete response to chemotherapy, 4(20%) received S-ISRT, 8(40%) RD-ISRT, and 8(40%) M-ISRT. The four-year progression-free survival was 94.7%. One relapse occurred at a non-CPLN site after RD-ISRT. The mean heart dose and volume of the heart that received 25 Gy was higher for S-ISRT patients compared to M-ISRT (p =.043 and p =.025, respectively). Re-planning the M-ISRT cases as S-ISRT resulted in significant increase in cardiac doses.

KW - Hodgkin lymphoma

KW - cardiophrenic lymph nodes

KW - radiation therapy

UR - http://www.scopus.com/inward/record.url?scp=85044955708&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044955708&partnerID=8YFLogxK

U2 - 10.1080/10428194.2018.1452211

DO - 10.1080/10428194.2018.1452211

M3 - Article

C2 - 29616834

AN - SCOPUS:85044955708

SN - 1042-8194

VL - 59

SP - 2650

EP - 2659

JO - Leukemia and Lymphoma

JF - Leukemia and Lymphoma

IS - 11

ER -

Omitting cardiophrenic lymph nodes in the treatment of patients with Hodgkin lymphoma via modified involved-site radiation therapy

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this