Radiation Therapy in the German Hodgkin Study Group HD 16 and HD 17 Trials: Quality Assurance and Dosimetric Analysis for Hodgkin Lymphoma in the Modern Era

Michael Oertel, MD; Dominik Hering, MSc; Nina Nacke, MSc; Christopher Kittel, MSc; Kai Kröger, MD; Jan Kriz, MD; Michael Fuchs, MD; Christian Baues, MD; Dirk Vordermark, MD; Rita Engenhart-Cabillic, MD; Klaus Herfarth, MD; Peter Lukas, MD; Heinz Schmidberger, MD; Simone Marnitz, MD; Peter Borchmann, MD; Andreas Engert, MD; Uwe Haverkamp; Hans Theodor Eich, MD

Advances in Radiation Oncology (May 2023)

Radiation Therapy in the German Hodgkin Study Group HD 16 and HD 17 Trials: Quality Assurance and Dosimetric Analysis for Hodgkin Lymphoma in the Modern Era

Michael Oertel, MD,
Dominik Hering, MSc,
Nina Nacke, MSc,
Christopher Kittel, MSc,
Kai Kröger, MD,
Jan Kriz, MD,
Michael Fuchs, MD,
Christian Baues, MD,
Dirk Vordermark, MD,
Rita Engenhart-Cabillic, MD,
Klaus Herfarth, MD,
Peter Lukas, MD,
Heinz Schmidberger, MD,
Simone Marnitz, MD,
Peter Borchmann, MD,
Andreas Engert, MD,
Uwe Haverkamp,
Hans Theodor Eich, MD

Affiliations

Michael Oertel, MD: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany; Corresponding author: Michael Oertel, MD
Dominik Hering, MSc: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
Nina Nacke, MSc: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
Christopher Kittel, MSc: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
Kai Kröger, MD: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
Jan Kriz, MD: Department of Radiation Oncology, Alexianer Clemenshospital Muenster, Muenster, Germany
Michael Fuchs, MD: Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
Christian Baues, MD: Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
Dirk Vordermark, MD: Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany
Rita Engenhart-Cabillic, MD: Department of Radiotherapy and Radiation Oncology, University Hospital Giessen-Marburg, Marburg, Germany
Klaus Herfarth, MD: Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
Peter Lukas, MD: Department of Radiooncology, Medical University Innsbruck, Innsbruck, Austria
Heinz Schmidberger, MD: Department of Radiotherapy and Radiation Oncology, University Hospital Mainz, Mainz, Germany
Simone Marnitz, MD: Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
Peter Borchmann, MD: Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
Andreas Engert, MD: Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
Uwe Haverkamp: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
Hans Theodor Eich, MD: Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany

Journal volume & issue: Vol. 8, no. 3
p. 101169

Abstract

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Purpose: Radiation therapy (RT) is an integral part of treatment concepts for early-stage Hodgkin lymphoma. This analysis reports on RT quality in the recent HD16 and 17 trials of the German Hodgkin Study Group (GHSG). Methods and Materials: All RT plans of involved-node radiation therapy (INRT) in HD 17 were requested for analysis, along with 100 and 50 involved-field radiation therapy (IFRT) plans in HD 16 and 17, respectively. A structured assessment regarding field design and protocol adherence was performed by the reference radiation oncology panel of the GHSG. Results: Overall, 100 (HD 16) and 176 (HD 17) patients were eligible for analysis. In HD 16, 84% of RT series were evaluated as correct, with significant improvement compared with the predecessor studies (P < .001). In HD 17, 76.1% of INRT cases revealed a correct RT design compared with 69.0% of IFRT-cases, which was superior to previous studies (P < .001). Comparing INRT and IFRT, we found no significant differences in the percentage of any deviation (P = .418) or major deviations (P = .466). Regarding dosimetry, INRT was accompanied by an improvement in thyroid doses. Comparing different RT techniques, we found that intensity-modulated RT showed a reduction of high doses in the lung at the expense of an increased low-dose exposure in HD 17. Conclusions: The latest study generation of the GHSG demonstrates an improved quality in RT. A modern INRT design could be established without deterioration in quality. On a conceptual level, an individual consideration of the appropriate RT technique has to be performed.

Published in Advances in Radiation Oncology

ISSN: 2452-1094 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/advances-in-radiation-oncology/

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