OncoLog, Volume 61, Number 3, March 2016 Page: Front Cover
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Innovations Decrease Toxic Effects of
Radiation Therapy for Mediastinal Tumors
from Hematological MalignanciesBy Bryan Tutt
Anterior mediastinal masses
caused by lymphoma or leukemia
can be difficult to treat because
sensitive tissues in the area are
vulnerable to damage from radia-
tion therapy. To treat these tumors
while sparing healthy tissue, radi-
ation oncologists at The Univer-
sity of Texas MD Anderson Cancer
Center use a combination of ad-
vanced technologies and new
techniques.
In addition to standard systemic treatments for their un-
derlying hematological malignancies, patients with anterior
mediastinal masses are treated with a radiation dose of 20-30
Gy delivered in daily fractions over 2-3 weeks. Patients with
refractory disease may receive a dose as high as 50 Gy over 5
weeks. Historically, treatment plans for these types of tumors
delivered the radiation dose using entirely anterior and rios-
terior radiation fields, such that substantial volumes of heart,
lung, and/or breast tissue were exposed to an unavoidable
radiation dose. Such treatment put patients at risk for car-
diotoxicity, radiation pneumonitis, and the development ofA treatment plan for intensity-modulated radiation therapy uses
the "butterfly technique" (so called because the radiation fields
resemble a butterfly's wings) to maximize the radiation dose to
the anterior mediastinal tumors (dark blue circles) while minimiz-
ing the dose to critical structures. Colored lines depict radiation
doses ranging from 3,300 cGy (innermost; purple) to 500 cGy
(outermost; pink). Image courtesy of Dr. Grace Smith.
secondary tumors in the lungs or breasts.
"Many patients with leukemia or lymphoma are very
young with a long lifetime to enjoy the benefits of the most
effective treatment or, conversely, to suffer long-term toxic
effects associated with treatment," said Grace Smith, M.D.,Transoral Robotic
Surgery
Minimally invasive
approach
3I I I
Implantable Cardiac
Monitoring Devices
Devices used during,
after cancer treatment
5House Call
Colorectal cancer
screening enables
early detection
7Useful
Resources
Clinical trials
information
84THE UNIVERSITY OF TEXAS
MD Anderson
Center
Making Cancer History'
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University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 61, Number 3, March 2016, periodical, March 2016; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth838490/m1/1/?q=%22United+States+-+Texas+-+Harris+County+-+Houston%22: accessed June 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.