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Vital organ sparing with proton therapy for pediatric Hodgkin lymphoma: Toxicity and outcomes in 50 patients.
Tringale, Kathryn R; Modlin, Leslie A; Sine, Kevin; Forlenza, Christopher J; Cahlon, Oren; Wolden, Suzanne L.
Affiliation
  • Tringale KR; Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, USA. Electronic address: tringalk@mskcc.org.
  • Modlin LA; Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, USA; ProCure Proton Therapy Center, Somerset, USA.
  • Sine K; ProCure Proton Therapy Center, Somerset, USA.
  • Forlenza CJ; Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, USA.
  • Cahlon O; Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, USA; ProCure Proton Therapy Center, Somerset, USA.
  • Wolden SL; Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, USA; ProCure Proton Therapy Center, Somerset, USA.
Radiother Oncol ; 168: 46-52, 2022 03.
Article in En | MEDLINE | ID: mdl-35101461
BACKGROUND AND PURPOSE: With high survival rates for pediatric Hodgkin lymphoma (HL), attention has turned to minimizing treatment-related morbidity and mortality. Chemotherapy and dose of radiation to organs at risk (OARs) contribute to elevated risks of secondary malignancy and cardiopulmonary disease. We sought to characterize the radiation dose to OARs, toxicities, and outcomes for pediatric HL patients treated with proton therapy (PT). MATERIALS AND METHODS: Fifty patients aged 11-21 with HL consecutively treated with PT were evaluated 1-2 months following completion of PT and every 6 months thereafter. Acute and late toxicities were captured retrospectively using CTCAE v5. Patterns of relapse were characterized, and survival was assessed using Kaplan-Meier method. RESULTS: Most (47, 94%) patients received PT to the mediastinum. Median mean heart dose was 4.3 Gy (RBE) and median bilateral lung V20Gy was 5.8%. Median integral dose was 1.7 Gy. For the 27 female patients, a median mean dose of 0.4 and 0.3 Gy (RBE) was delivered to ipsilateral and contralateral breast tissue, respectively. No on-treatment grade 3-5 toxicities were seen. At a median follow-up of 5.3 years, no PT-related grade 3-5 toxicities or secondary malignancies developed. Five patients relapsed at a median time of 9.2 months after PT (range 2.5-24.9 months; 5-year recurrence free survival 90%). Recurrences were both in- and out-of-field in all 5 cases with no marginal failures. All relapsed patients were successfully salvaged (5-year overall survival 100%). CONCLUSION: For pediatric HL patients, proton treatment resulted in marked dose sparing of OARs with low rates of toxicity, no marginal failures, and excellent 5-year survival.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hodgkin Disease / Proton Therapy Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Female / Humans Language: En Journal: Radiother Oncol Year: 2022 Type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hodgkin Disease / Proton Therapy Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Adolescent / Adult / Child / Female / Humans Language: En Journal: Radiother Oncol Year: 2022 Type: Article