Radiotherapy in Anterior Mediastinum Cancers

  • Alfonso ReginelliEmail author
  • Anna Russo
  • Fernando Scala
  • Elisa Micheletti
  • Roberta Grassi
  • Mario Santini
  • S. Cappabianca
Part of the Current Clinical Pathology book series (CCPATH)


Radiotherapy treatment in anterior mediastinum cancers can be performed with curative, adjuvant, palliative/symptomatic intent. The mediastinal tumors of radiotherapy interest are represented by thymic tumors, mediastinal localization of lymphomas, germinal tumors, and superior vena cava obstruction (SVCO). For the first two groups of tumors, the therapy is established according to the staging of the disease. For the germinal tumors, radiotherapy in non-seminomatous forms has a secondary role only in residual disease after systemic therapy. Superior vena cava syndrome (SVCS) is caused by the evolution and expansion of intrathoracic tumors or by the affected mediastinal lymph nodes, and the treatment is according to the primitive tumor.


Radiotherapy Mediastinal masses Germinal tumors Superior vena cava obstruction Thymic tumors 


  1. 1.
    Truong MT, Sabloff BS, Gladish GW, et al. Invasive thymoma. AJR Am J Roentgenol. 2003;181(6):1504. Scholar
  2. 2.
    Wilkins KB, Sheikh E, Green R, et al. Clinical and pathologic predictors of survival in patients with thymoma. Ann Surg. 1999;230(4):562–72.CrossRefGoogle Scholar
  3. 3.
    Lee HS, Kim ST, Lee J, et al. A single institutional experience of thymic epithelial tumours over 11 years: clinical features and outcome and implications for future management. Br J Cancer. 2007;97(1):22–8. Scholar
  4. 4.
    Kim DJ, Yang WI, Choi SS, et al. Prognostic and clinical relevance of the World Health Organization schema for the classification of thymic epithelial tumors: a clinicopathologic study of 108 patients and literature review. Chest. 2005;127(3):755–61. Scholar
  5. 5.
    Yahalom J, Mauch P. The involved field is back: issues in delineating the radiation field in Hodgkin’s disease. Ann Oncol. 2002;13(Suppl 1):79–83.CrossRefGoogle Scholar
  6. 6.
    Girinsky T, van der Maazen R, Specht L, et al. Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol. 2006;79(3):270–7.CrossRefGoogle Scholar
  7. 7.
    Specht L, Yahalom J, Illidge T, et al. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys. 2014;89(4):854–62.CrossRefGoogle Scholar
  8. 8.
    Illidge T, Specht L, Yahalom J. Modern radiation therapy for nodal non-Hodgkin lymphoma—target definition and dose guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys. 2014;89(1):49–58.CrossRefGoogle Scholar
  9. 9.
    Torok JA, Wu Y, Chino J, Prosnitz LR, Beaven AW, Kim GJ, Kelsey CR. Chemoterapy or combined modality therapy for early-stage Hodgkin lymphoma. Anticancer Res. 2018;38(5):2875–81.Google Scholar
  10. 10.
    Meyer RM, Gospodarowicz MK, Connors JM, et al. ABVD alone versus radiation-based therapy in limited-stage Hodgkin’s lymphoma. N Engl J Med. 2012;366(5):399–408.CrossRefGoogle Scholar
  11. 11.
    Engert A, Plutschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363(7):640–52.CrossRefGoogle Scholar
  12. 12.
    Milgrom SA, Dong W, Akhtari M, Smith GL, Pinnix CC, Mawlawi O, Rohren E, Garg N, Chuang H, Yehia ZA, Reddy JP, Gunther JR, Khoury JD, Suki T, Osborne EM, Oki Y, Fanale M, Dabaja BS. Chemotherapy response assessment by FDG-PET-CT in early-stage classical Hodgkin lymphoma: moving beyond the five-point Deauville score. Int J Radiat Oncol Biol Phys. 2017;97(2):333–8. Epub 2016 Oct 22.CrossRefPubMedGoogle Scholar
  13. 13.
    Hoppe RT, Advani RH, Ai WZ, et al. Hodgkin lymphoma, version 2.2012 featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2012;10(5):589–97.CrossRefGoogle Scholar
  14. 14.
    Hoppe BS, Flampouri S, Su Z, et al. Consolidative involved-node proton therapy for Stage IA-IIIB mediastinal Hodgkin lymphoma: preliminary dosimetric outcomes from a Phase II study. Int J Radiat Oncol Biol Phys. 2012;83(1):260–7.CrossRefGoogle Scholar
  15. 15.
    Parish JM, Marschke RF Jr, Dines DE, Lee RE. Etiologic considerations in superior vena cava syndrome. Mayo Clin Proc. 1981;56(7):407–13.PubMedGoogle Scholar
  16. 16.
    Lochridge SK, Knibbe WP, Doty DB. Obstruction of the superior vena cava. Surgery. 1979;85(1):14–24.PubMedGoogle Scholar
  17. 17.
    Nogeire C, Mincer F, Botstein C. Long survival in patients with bronchogenic carcinoma complicated by superior vena caval obstruction. Chest. 1979;75(3):325–9.CrossRefGoogle Scholar
  18. 18.
    Perez-Soler R, McLaughlin P, Velasquez WS, Hagemeister FB, Zornoza J, Manning JT, et al. Clinical features and results of management of superior vena cava syndrome secondary to lymphoma. J Clin Oncol. 1984;2(4):260–6.CrossRefGoogle Scholar
  19. 19.
    Yahalom J. Superior vena cava syndrome. In: De Vita VT, Hellman S, Rosenberg SA, editors. Cancer—principles and practice of oncology. 4th ed. Philadelphia: JB Lippincott; 1993. p. 2111–8.Google Scholar
  20. 20.
    Armstrong BA, Perez CA, Simpson JR, Hederman MA. Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys. 1987;13(4):531–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Alfonso Reginelli
    • 1
    Email author
  • Anna Russo
    • 1
  • Fernando Scala
    • 1
  • Elisa Micheletti
    • 1
  • Roberta Grassi
    • 2
  • Mario Santini
    • 3
  • S. Cappabianca
    • 1
  1. 1.Radiology and Radiotherapy Unit, Department of Clinical and Experimental MedicineUniversità degli Studi della Campania “Luigi Vanvitelli”NaplesItaly
  2. 2.Radiotherapy Unit, Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”University of FlorenceFlorenceItaly
  3. 3.Thoracic Surgery Unit, Department of Translational Medical ScienceUniversità degli Studi della Campania ‘Luigi Vanvitelli’NaplesItaly

Personalised recommendations