Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Absence of a dose-response relationship has been reported for local control of Hodgkin's disease between 30 and 42 Gy delivered to the mantle field in definitive irradiation. These dose ranges were determined at the central ray using irregular field (IF) calculations without benefit of dosimetric correction for lung inhomogeneity. Detailed analysis was performed of dose delivered to hilar and mediastinal regions with mantle field irradiation incorporating lung inhomogeneity corrections for the indicated dose ranges using 60Co and 6 MV linear accelerator. ⋯ Mantle field calculations should be performed with CT planning including lung inhomogeneity corrections to account for anatomic irregularity of the mediastinal contour and interposed lung. As lung inhomogeneity dosimetric data become available, conclusions drawn from clinical experience should be re-evaluated based upon location and extent of mediastinal disease involvement. Implications for treatment associated late toxicity using dose-volume histogram analysis should be considered.