Mediastinal Hodgkin's disease: dosimetric study of intensity-modulated radiotherapy combined with the deep-inspiration breath-hold technique

The authors report a study which aimed to assess the additional benefits of using the deep-inspiration breath-hold (DIBH) technique with intensity-modulated radiotherapy (IMRT) in terms of protection of organs at risk for patients with mediastinal Hodgkin's disease. Two simulation computed tomography scans were performed for each patient: one using the free-breathing (FB) technique and the other using the DIBH technique with a dedicated spirometer. The clinical target volume, planning target volume (PTV), and organs at risk were determined on both computed tomography scans according to the guidelines of the European Organization for Research and Treatment of Cancer. There were no significant differences in PTV coverage between the two techniques (FB vs. DIBH). The mean doses delivered to the coronary arteries, heart, and lungs were significantly reduced by 10% to 20% using DIBH compared with FB. The greatest benefit was obtained for tumours in the upper part of the mediastinum. Short communication