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Dosimetric Correlation of Pneumonitis in Pediatric Sarcoma and Hodgkin s Lymphoma Patients Receiving Radiation Therapy
Hoth, Kelly Ann
Hoth, Kelly Ann
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Text, Honors papers, Chemistry, Department of
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Abstract
Pediatric sarcoma and Hodgkin s lymphoma patients often receive radiation therapy for
local tumor control. Unfortunately, radiation can be deleterious to the healthy tissues
adjacent to the target volume, leading to acute effects including radiation pneumonitis.
Characterized by a cough, fever, and shortness of breath, radiation pneumonitis or
inflammation of the lung develops in 5% to 15% of patients receiving thoracic
irradiation. In this study, clinical complication data on radiation pneumonitis and dosevolume
data for the lung were reviewed for 40 patients with Hodgkin s lymphoma and 23
patients with thoracic sarcomas; this enabled evaluation of the applicability of dosevolume
constraints derived from adult lung cancer patients and determination of
dosimetric planning guidelines for pediatric lung. Three of the Hodgkin s lymphoma
patients and one of the sarcoma patients developed radiation pneumonitis within six
months of radiotherapy. Only one patient from each tumor type required the use of
steroids (CTC grade 2) for the management of their radiation pneumonitis. Of the three
patients with Hodgkin s lymphoma who developed radiation pneumonitis, two received 8
Gy to their entire right lung. Patients presenting with grade 2 pneumonitis had higher
total lung DVHs, a V20 ≥ 35%, and a mean lung dose above 16 Gy. Findings suggest that
irradiated volume and delivered dose may be used in the clinical setting to predict
patients at risk for development of pneumonitis. Early intervention in this group of
patients may help reduce or eliminate radiation-induced lung side effects.