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Proton Therapy Provides Safe, Long-Term Treatment for Hodgkin Lymphoma

By Medimaging International staff writers
Posted on 07 Jul 2014
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Image: An axial CT scan slice through the heart (red) of a patient with Hodgkin lymphoma involving the mediastinum. On the left is the X-ray plan and on the right is the proton plan. The dark blue line in both represents the tumor and target area for the radiation. The green line represents the volume of the body receiving 95% of the total prescribed dose of radiation, while the light blue line reflects the volume of the body receiving 10% of the total prescribed radiation dose. As is apparent, with conventional radiation (left), the X-rays deposit more radiation in the heart and breasts than the proton plan. In fact, the proton plan reduced the mean dose to the heart by more than 50% and the mean dose to the breast by 70%. For this reason, it’s believed that Hodgkin lymphoma patients will have a much lower risk of heart disease and second malignancy with proton therapy than what’s been observed in the past with conventional radiation therapy (Photo courtesy of the University of Florida Proton Therapy Institute).
Image: An axial CT scan slice through the heart (red) of a patient with Hodgkin lymphoma involving the mediastinum. On the left is the X-ray plan and on the right is the proton plan. The dark blue line in both represents the tumor and target area for the radiation. The green line represents the volume of the body receiving 95% of the total prescribed dose of radiation, while the light blue line reflects the volume of the body receiving 10% of the total prescribed radiation dose. As is apparent, with conventional radiation (left), the X-rays deposit more radiation in the heart and breasts than the proton plan. In fact, the proton plan reduced the mean dose to the heart by more than 50% and the mean dose to the breast by 70%. For this reason, it’s believed that Hodgkin lymphoma patients will have a much lower risk of heart disease and second malignancy with proton therapy than what’s been observed in the past with conventional radiation therapy (Photo courtesy of the University of Florida Proton Therapy Institute).
In spite of various successes in treating patients with Hodgkin lymphoma, many patients suffer from the late effects of radiation therapy and chemotherapy treatment, including the possible onset of breast cancer or heart disease.

A study by the University of Florida (UF) Proton Therapy Institute (Jacksonville, USA) revealed that the use of proton therapy following chemotherapy in patients with Hodgkin lymphoma has a success rate similar to the conventional treatments with a reduction of radiation outside of the target area, or “involved-node,” potentially reducing the risk of late effects caused by radiation.

The phase II study was published June 11, 2014, in the online edition of the International Journal of Radiation Oncology Biology Physics and adds to the increasing evidence supporting the use of proton Radiotherapy for positive long-term treatment outcomes. Several retrospective dosimetry studies, measuring the radiation dose in tissue resulting from exposure to direct and/or indirect radiation, have reported the advantages of proton therapy in Hodgkin lymphoma as a way of cutting the radiation dose to the organs at risk, such as the lungs, heart, and breast. However, this study is the first of its kind to track the proton therapy treatment findings on patients with Hodgkin lymphoma.

The research monitored 15 patients between September 2009 and June 2013 with newly diagnosed Hodgkin lymphoma as they received involved-node proton therapy (INPT), which specifically targets initially involved lymph node(s) containing the Hodgkin lymphoma, after completing chemotherapy. Further, the study evaluated the radiation dose in the surrounding healthy tissue as a result of proton therapy compared with conventional treatments, called intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3DCRT).

The data show a three-year relapse-free rate of 93% and a three-year event-free rate of 87%. Furthermore, no patients developed grade three or higher toxicity during follow-up. “All 15 patients derived benefits from using proton therapy. The results show that the use of protons, as opposed to similar conventional photon therapy, reduced the risk of long-term side effects by reducing or eliminating radiation doses to healthy tissue without compromising the cure rate,” said lead researcher Bradford S. Hoppe, MD, a radiation oncologist from the UF Proton Therapy Institute, and assistant professor in the University of Florida College of Medicine department of radiation oncology. “Three years after the [US] National Comprehensive Cancer Network guidelines endorsed the use of proton therapy, this study reinforces proton therapy as a safe alternative to the more conventional forms of radiation,” Dr. Hoppe concluded.

Related Links:

University of Florida Proton Therapy Institute



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