S522
Clinical - Haemotology
ESTRO 2026
Conclusion: Unexpectedly, in this cohort of young women treated with 3DCRT, mediastinal OOI doses did not significantly decrease between 2005-2021. Possible explanations include a dominant effect of inter-patient variation or a change in referral patterns for radiotherapy. Average mean breast doses were <2Gy, which is reassuring and considerably lower than reported doses from older radiotherapy techniques [2]. The apparent decrease in mean lung dose may reflect the introduction of deep-inspiration breath- hold in 2019. This work suggests the need to optimise breast screening strategies based on individual risk assessment in young women treated for HL. Future work will include patients treated more recently with intensity-modulated techniques. References: [1] Andreas Engert Et Al. Involved-Field Radiotherapy Is Equally Effective and Less Toxic Compared With Extended-Field Radiotherapy After Four Cycles of Chemotherapy in Patients With Early-Stage Unfavorable Hodgkin’s Lymphoma: Results Of The HD8 Trial of the German Hodgkin’s Lymphoma Study Group. Journal Of Clinical Oncology, 2003.[2] Roberti, Sander, et al. "Prediction of breast cancer risk for adolescents and young adults with Hodgkin lymphoma." JNCI: Journal of the National Cancer Institute 117.4 (2025): 619-628 Keywords: late-effects, screening guidelines, radiotherapy Clinical Implementation of a Novel Total Marrow and Lymphoid Irradiation Program Using Multi- Isocenter VMAT on a Ring-Gantry Linac Hernan Letelier 1 , Nicole Melej 2 , Alexis Troncoso 3,1 , Rixy Plata 1 , Filippo Marangoni 1 , Marcelo Ribeiro Picioli 1 , Jorge Vasquez 1 , Maria Paz Yanez 1 , Maria Fernanda Sanchez 1 , Doris Atariguana 1 , Pablo Ramirez 4 1 Servicio de Radioterapia Avanzada, Fundación Arturo López Pérez, Santiago, Chile. 2 Escuela de Postgrado de Medicina, Universidad de Los Andes, Santiago, Chile. 3 Departamento de Tecnología Médica, Universidad de Chile, Santiago, Chile. 4 Servicio de Hematologia, Fundación Arturo López Pérez, Santiago, Chile Digital Poster 4539
Digital Poster 4659
Dosimetric analysis of cardiac conduction system exposure in mediastinal IMRT /VMAT for Hodgkin lymphoma: A retrospective study on Halcyon Boubaker Abir 1 , Bettaieb Ons 1 , sghaier Sarra 1 , Abdessaied Siwar 1 , Felfoul Asma 2 , Zanzouri Rim 1 , Chamsi Amal 1 , Tbessi Sabrine 1 , Yazid Dalia 1 , Bouzid Nadia 1 , Kanoun Samia 1 , Tebra Sameh 1 1 Radiotherapy Oncology department, Farhat hached Hospital, Sousse, Tunisia. 2 Oncology department, Fattouma Bourguiba Hospital, Monastir, Tunisia Purpose/Objective: Mediastinal radiotherapy is a key component in the treatment of Hodgkin lymphoma (HL); however, it is associated with long-term cardiac toxicity. The cardiac conduction system (CCS) is particularly vulnerable to arrhythmias, yet its radiation dose constraints remain underexplored. This study aims to retrospectively evaluate CCS exposure in patients with mediastinal HL treated with intensity-modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT) on Halcyon. Material/Methods: A retrospective dosimetric study was conducted in the Radiotherapy Department of Farhat Hached Hospital, Sousse. We included 8 patients treated with either VMAT or IMRT for mediastinal Hodgkin lymphoma between April 2024 and March 2025. The CCS was retrospectively delineated following the Radiotherapy Contouring Atlas for Cardiac Conduction Node Delineation, and dose constraints were analyzed. Results: Among the 8 patients (6 males, 2 females; median age: 31 years). All pateient had stade II Hodgkin lymphoma and were treated with initial Chemotherapy followed by involved-site radiotherapy. All patients received
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