Fig. 16.1
Shows the distribution dose during radiotherapy of an old female patient who was diagnosed with pelvic lesion from high grade lymphoma and who was unable to support the chemotherapy and rituximab treatment (she stopped her treatment after 1 cycle). Dose-volumes histograms evidence accurate sparing of some organs at risk, especially the digestive system
Fig. 16.2
Irradiation using helical tomotherapy of localized recurrence in 75 years old patient treated for multiple myeloma with chemotherapy and stem cell transplantation (dose distribution)
Fig. 16.3
Irradiation of low grade lymphoma in 73 old patient using electron beams
Conclusion
There is growing dosimetric evidence that highly conformal irradiation modalities may improve critical organs sparing, with clinically relevant consequences. Prospective clinical evaluation in needed to confirm the potential benefits of highly conformal therapies applied to hematological malignancies in elderly.
Acknowledgements
To Dr. C. Chargary for his precious help
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