Percussion assisted radiation therapy in Hodgkin lymphoma allows a marked reduction in heart dose. (November 2020)

• Record Type: Journal Article
• Authors: Durham, André-Dante; Lovis, Alban; Simons, Julien; Long, Olivier; Buela, Flore; Ogna, Adam; Jumeau, Raphaël; Cairoli, Anne; Rocha Do Carmo Leal, Susana; Zeverino, Michele; Patin, David; Vallet, Véronique; Moeckli, Raphaël; Bourhis, Jean; Ozsahin, Mahmut
• Is Part Of: Radiotherapy and oncology. Volume 152(2020)
• Page Start: 163
• Page End: 168
• Publication Date: 2020-11
• Subjects: Respiratory motion -- Radiotherapy -- Hodgkin disease; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2019.11.009
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: We previously showed that high frequency percussion could induce "apnea-like" lung stabilisation of 20 min or more. This percussion assisted radiotherapy was routinely used in a series of patients with Hodgkin lymphoma. All treatment sessions were performed safely without interruption. A significant and clinically meaningful reduction of the dose to the heart was observed. This is the first evidence of a potential benefit associated with this technique. 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.