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The use of modern RT techniques like intensity-modulated radiotherapy (IMRT) is gaining interest to spare organs at risk.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We evaluated 27\u00a0patients who underwent RT for Hodgkin\u2019s lymphoma between 2009 and 2013\u202fat our institution. For each patient, three different treatment plans for a\u00a030-Gy involved-field RT (IFRT) were created (anterior-posterior-posterior-anterior setup [APPA], 5\u2011field IMRT, and 7\u2011field IMRT) and analyzed concerning their inherent \u201cnormal tissue complication probability\u201d (NTCP) for pneumonitis and secondary pulmonary malignancy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The comparison of different radiation techniques showed a\u00a0significant difference in favor of standard APPA (<jats:italic>p<\/jats:italic>\u202f&lt;\u20090.01). The risk of lung toxicity was significantly higher in plans using 7\u2011field IMRT than in plans using 5\u2011field IMRT. The absolute juxtaposition showed an increase in risk for radiation pneumonitis of 1% for plans using 5\u2011field IMRT over APPA according to QUANTEC (Quantitative Analyses of Normal Tissue Effects in the Clinic) parameters (Burman: 0.15%) and 2.6% when using 7\u2011field IMRT over APPA (Burman: 0.7%) as well as 1.6% when using 7\u2011field IMRT over 5\u2011field IMRT (Burman: 0.6%). Further analysis showed an increase in risk for secondary pulmonary malignancies to be statistically significant (<jats:italic>p<\/jats:italic>\u202f&lt;\u20090.01); mean induction probability for pulmonary malignoma was 0.1% higher in plans using 5\u2011field IMRT than APPA and 0.19% higher in plans using 7\u2011field IMRT than APPA as well as 0.09% higher in plans using 7\u2011field IMRT than 5\u2011field IMRT. During a\u00a0median follow-up period of 65\u00a0months (95% confidence interval: 53.8\u201376.2\u00a0months), only one patient developed radiation-induced pneumonitis. No secondary pulmonary malignancies have been detected to date.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Radiation-induced lung toxicity is rare after treatment for Hodgkin lymphoma but may be influenced significantly by the RT technique used. In this study, APPA RT plans demonstrated a\u00a0decrease in potential radiation pneumonitis and pulmonary malignancies. Biological planning using NTCP may have the potential to define personalized RT strategies<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-020-01682-0","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T12:06:13Z","timestamp":1600430773000},"page":"56-62","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Impact of radiation techniques on lung toxicity in patients with mediastinal Hodgkin\u2019s lymphoma"],"prefix":"10.1007","volume":"197","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5917-4203","authenticated-orcid":false,"given":"Niklas Benedikt","family":"Pepper","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Oertel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Kittel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai Jannes","family":"Kr\u00f6ger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Elsayad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe","family":"Haverkamp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Theodor","family":"Eich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,9,18]]},"reference":[{"key":"1682_CR1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.0750","author":"PJ Br\u00f6ckelmann","year":"2020","unstructured":"Br\u00f6ckelmann\u00a0PJ, Goergen\u00a0H, Keller\u00a0U, Meissner\u00a0J, Ordemann\u00a0R, Halbsguth\u00a0TV et al (2020) Efficacy of nivolumab and AVD in early-stage unfavorable classic hodgkin lymphoma: the randomized phase 2 German hodgkin study group NIVAHL trial. 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For this type of study, formal consent is not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}