S511
Clinical - Haemotology
ESTRO 2026
Digital Poster 2904
Assessment of PET-CT based pre-treatment risk factors to predict the dose to OARs in patients with Hodgkin Lymphoma involving the mediastinum Andrea E Guerini 1,2 , Mariateresa Cefaratti 1 , Althea Carlino 1 , Ludovica Pegurri 2 , Paolo Borghetti 2 , Luca Triggiani 1,2 , Marco L Bonù 2 , Davide Tomasini 2 , Stefania Nici 3 , Stefano Riga 3 , Giorgio Facheris 2 , Gianluca Cossali 2 , Eneida Mataj 1 , Martina Peretti 3 , Martina C Daniotti 3 , Anna Pederzoli 3 , Chiara Valietti 1 , Claudia Cozzaglio 3 , Cristian Toraci 3 , Stefano M Magrini 1,4 , Luigi Spiazzi 3,4 , Michela Buglione di Monale 1,4 1 Radiation Oncology, Università degli Studi di Brescia, Brescia, Italy. 2 Radiation Oncology, ASST Spedali Civili di Brescia, Brescia, Italy. 3 Medical Physics, ASST Spedali Civili di Brescia, Brescia, Italy. 4 Radiation Oncology, Centro Bio-RT, Brescia, Italy Purpose/Objective: The aim of this study is to identify parameters from pre-chemoterapy PET-CT that could allow to predict dose to the OARs and therefore identify patients at increased risk of secondary malignancies and late cardiovascular toxicities. This could help to tailor therapeutic choices, remarkably in young patients and those with pre-existing comorbidities. Material/Methods: We retrospectively analyzed data of patients treated at our Institution between January 2018 and May 2025 and identified subjects affected by stage I-II HL that received CHT and subsequent RT on mediastinal sites. We excluded patients with incomplete data regarding treatment plan and/or pre-chemotherapy PET- CT.Elekta Monaco v. 6.2 TPS was used to calculate the following parameters from pre-chemotherapy PET-CT: mediastinal metabolic tumor volume (MMTV), defined as tumor volume with a SUV over 2.5 localized in the mediastinum, sub-carinal MMTV, maximum and sub- carinal cranio-caudal and latero-lateral diameter of disease extension (measuring as disease sites with an uptake with a SUV over 2.5). We assessed correlation between these features and violation of main dosimetric constraints to the OARs, summarized in Table 1.
Conclusion: DIBH is likely to reduce both mean heart and lung dose in mediastinal lymphoma radiotherapy. Future research is needed to improve insight in the most optimal breath-hold technique to reduce dose to organs of interest. References: [1] Van Nimwegen FA, Schaapveld M, Cutter DJ, Janus CPM, Krol ADG, et al. Radiation dose-response relationship for risk of coronary heart disease in survivors of Hodgkin lymphoma. J Clin Oncol 2016;34:235–43.[2] Murray L, Sethugavalar B, Robertshaw H, Bayman E, Thomas E, et al. Involved Node, Site, Field and Residual Volume Radiotherapy for Lymphoma: A Comparison of Organ at Risk Dosimetry and Second Malignancy Risks. Clin Oncol 2015;27:401– 10. https://doi.org/10.1016/j.clon.2015.03.005.[3] Van Leeuwen FE, Klokman WJ, Stovall M, Dahler EC, Van’t Veer MB, et al. Roles of Radiation Dose, Chemotherapy, and Hormonal Factors in Breast Cancer Following Hodgkin’s Disease. J Natl Cancer Inst 2003;95:971– 80. https://doi.org/10.1093/jnci/95.13.971. Keywords: Mediastinal lymphoma, Breath-hold, Dosimetry
Normality of the distributions was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Non- parametric analyses used Mann-Whitney U, Pearson’s χ² , and Fisher’s exact tests; multivariable linear and
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