Cardiac conduction system exposure with modern radiotherapy techniques for mediastinal Hodgkin lymphoma irradiation

Figures & data

Figure 1. Cardiac conduction node exposure during mediastinal Hodgkin lymphoma irradiation with volumetric modulated arc therapy (VMAT) or intensity modulated proton therapy (IMPT) with deep-inspiration breath-hold (DIBH). (a) Mean doses delivered to the heart, to the sino-atrial node (SAN) and to the atrio-ventricular node (AVN). (b) Maximum doses delivered to the heart, to the SAN and to the AVN. Individual values are represented by red spots. (c) Example of conduction node exposure with volumetric modulated arc therapy (VMAT) and intensity modulated proton therapy (IMPT): Sinoatrial node is delineated in green, atrio-ventricular node in blue, and the heart in orange. The CTV, defined according to the involved-site radiation therapy (ISRT) standard, is delineated in red.

Table 1. Pearson correlation coefficients (r) between doses to the heart and doses to the atrio-ventricular node (AVN) or to the sinoatrial node (SAN), with volumetric modulated arctherapy (VMAT) or intensity modulated proton therapy (IMPT).

	Mean dose correlation		Maximum dose correlation
	Heart – SAN	Heart – AVN	Heart – SAN	Heart – AVN
VMAT	r = 0.72	r = 0.87	r = 0.42	r = 0.39
IMPT	r = 0.65	r = 0.68	r = 0.18	r = 0.21

Data availability statement

Research data are stored in an institutional repository and will be shared upon request to the corresponding author