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Radiation therapy with mantle field for malignant lymphoma

General

A standard mantle field includes all lymph node stations over the diaphragm. The mantle field originated as extended field treatment of supradiaphragmal spreading of Hodgkin's lymphoma.  

The standard mantle field is rarely used today, but many long-term survivors of HL have received this treatment. Many examples of involved field radiation therapy to the diaphragm can be considered a section of the mantle field. Further, fields with sizes close to a mantle field are also considered involved field irradiation in some situations today. It is therefore advantageous to know the principles for modeling a mantle field as for the inverted Y field.

  • High mantle field includes treatment of the upper cervical lymph nodes (preaurciular and possibly retroauricular lymph nodes) and Waldeyer's ring including the tonsil field.
  • Low mantle field includes the submental, submandibular, and nuchal lymph nodes as the upper stations. The upper field border was at the level of the point of the chin and the bottom of the posterior skull.
  • Minimantle was the expression for fields where the mediastinum could be excluded. 

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