A Systematic Review on Intensity Modulated Radiation Therapy for Mediastinal Hodgkin's Lymphoma

Michela Buglione, Andrea Emanuele Guerini, Andrea Riccardo Filippi, Luigi Spiazzi, Nadia Pasinetti, Alessandro Magli, Cristian Toraci, Paolo Borghetti, Luca Triggiani, Alessandro Alghisi, Gianluca Costantino, Francesco Bertagna, Niccolò Giaj Levra, Ludovica Pegurri, Stefano Maria Magrini

Research output: Contribution to journalReview articlepeer-review


Background: Secondary malignant neoplasms (SMNs) and cardiovascular diseases induced by chemotherapy and radiotherapy represent the main cause of excess mortality for early-stage Hodgkin lymphoma patients, especially when the mediastinum is involved. Conformal radiotherapy techniques such as Intensity-Modulated Radiation Therapy (IMRT) could allow a reduction of the dose to the organs-at-risk (OARs) and therefore limit long-term toxicity. Methods: We performed a systematic review of the current literature regarding comparisons between IMRT and conventional photon beam radiotherapy, or between different IMRT techniques, for the treatment of mediastinal lymphoma. Results and conclusions: IMRT allows a substantial reduction of the volumes of OARs exposed to high doses, reducing the risk of long-term toxicity. This benefit is conterbalanced by the increase of volumes receiving low doses, that could potentially increase the risk of SMNs. Treatment planning should be personalized on patient and disease characteristics. Dedicated techniques such as “butterfly” VMAT often provide the best trade-off.

Original languageEnglish
Article number103437
JournalCritical Reviews in Oncology/Hematology
Publication statusPublished - Nov 2021


  • cardiovascular
  • conformal
  • IMRT
  • intensity modulated
  • lymphoma
  • mediastinal
  • radiotherapy
  • secondary cancer

ASJC Scopus subject areas

  • Hematology
  • Oncology


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