+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Consolidative involved-node proton therapy for Stage IA-IIIB mediastinal Hodgkin lymphoma: preliminary dosimetric outcomes from a Phase II study



Consolidative involved-node proton therapy for Stage IA-IIIB mediastinal Hodgkin lymphoma: preliminary dosimetric outcomes from a Phase II study



International Journal of Radiation Oncology, Biology, Physics 83(1): 260-267



To compare the dose reduction to organs at risk (OARs) with proton therapy (PT) versus three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with mediastinal Hodgkin lymphoma (HL) enrolled on a Phase II study of involved-node radiotherapy (INRT). Between June 2009 and October 2010, 10 patients were enrolled on a University of Florida institutional review board-approved protocol for de novo "classical" Stage IA-IIIB HL with mediastinal (bulky or nonbulky) involvement after chemotherapy. INRT was planned per European Organization for Research and Treatment of Cancer guidelines. Three separate optimized plans were developed for each patient: 3D-CRT, IMRT, and PT. The primary end point was a 50% reduction in the body V4 with PT compared with 3D-CRT or IMRT. The median relative reduction with PT in the primary end point, body V4, was 51% compared with 3D-CRT (p = 0.0098) and 59% compared with IMRT (p = 0.0020), thus all patients were offered treatment with PT. PT provided the lowest mean dose to the heart, lungs, and breasts for all 10 patients compared with either 3D-CRT or IMRT. The median difference in the OAR mean dose reduction with PT compared with 3D-CRT were 10.4 Gy/CGE for heart; 5.5 Gy/CGE for lung; 0.9 Gy/CGE for breast; 8.3 Gy/CGE for esophagus; and 4.1 Gy/CGE for thyroid. The median differences for mean OAR dose reduction for PT compared with IMRT were 4.3 Gy/CGE for heart, 3.1 Gy/CGE for lung, 1.4 Gy/CGE for breast, 2.8 Gy/CGE for esophagus, and 2.7 Gy/CGE for thyroid. All 10 patients benefitted from dose reductions to OARs with PT compared with either 3D-CRT or IMRT. It is anticipated that these reductions in dose to OAR will translate into lower rates of late complications, but long-term follow-up on this Phase II INRT study is needed.

(PDF emailed within 0-6 h: $19.90)

Accession: 052308777

Download citation: RISBibTeXText

PMID: 22014950

DOI: 10.1016/j.ijrobp.2011.06.1959


Related references

Phase 2 Study of Consolidative Involved-Node Proton Therapy in Patients With Hodgkin Lymphoma: Early Outcomes. International Journal of Radiation Oncology*biology*physics 87(2): S162-S163, 2013

Dosimetric and clinical outcomes of involved-field intensity-modulated radiotherapy after chemotherapy for early-stage Hodgkin's lymphoma with mediastinal involvement. International Journal of Radiation Oncology, Biology, Physics 84(1): 210-216, 2012

Involved-node proton therapy in combined modality therapy for Hodgkin lymphoma: results of a phase 2 study. International Journal of Radiation Oncology, Biology, Physics 89(5): 1053-1059, 2014

Minimising critical organ irradiation in limited stage Hodgkin lymphoma: a dosimetric study of the benefit of involved node radiotherapy. Annals of Oncology 23(5): 1259-1266, 2012

Proton therapy in mediastinal Hodgkin lymphoma: moving from dosimetric prediction to clinical evidence. Annals of Oncology 28(9): 2049-2050, 2017

Radiation-induced second malignancies after involved-node radiotherapy with deep-inspiration breath-hold technique for early stage Hodgkin Lymphoma: a dosimetric study. Radiation Oncology 9: 58, 2014

Consolidative mediastinal irradiation of malignant lymphoma using active scanning proton beams: clinical outcome and dosimetric comparison. Strahlentherapie und Onkologie 2019, 2019

Consolidative proton therapy after chemotherapy for patients with Hodgkin lymphoma. Annals of Oncology 28(9): 2179-2184, 2018

Cardiac sparing with proton therapy in consolidative radiation therapy for Hodgkin lymphoma. Leukemia and Lymphoma 51(8): 1559-1562, 2010

Dosimetric comparison of involved-field three-dimensional conformal photon radiotherapy and breast-sparing proton therapy for the treatment of Hodgkin's lymphoma in female pediatric patients. International Journal of Radiation Oncology, Biology, Physics 81(4): E667-E671, 2012

Interobserver delineation uncertainty in involved-node radiation therapy (INRT) for early-stage Hodgkin lymphoma: on behalf of the Radiotherapy Committee of the EORTC lymphoma group. Acta Oncologica 56(4): 608-613, 2017

Interobserver Delineation Uncertainty in Involved Node Therapy for Early-Stage Hodgkin Lymphoma. International Journal of Radiation Oncology*biology*physics 96(2): E490-E491, 2016

Involved node radiation therapy: an effective alternative in early-stage hodgkin lymphoma. International Journal of Radiation Oncology, Biology, Physics 85(4): 1057-1065, 2013

Dosimetric comparison of three different involved nodal irradiation techniques for stage II Hodgkin's lymphoma patients: conventional radiotherapy, intensity-modulated radiotherapy, and three-dimensional proton radiotherapy. International Journal of Radiation Oncology, Biology, Physics 75(4): 1173-1180, 2009

Radiotherapy for early mediastinal Hodgkin lymphoma according to the German Hodgkin Study Group (GHSG): the roles of intensity-modulated radiotherapy and involved-node radiotherapy. International Journal of Radiation Oncology, Biology, Physics 83(1): 268-276, 2012