PMID- 22014950
OWN - NLM
STAT- MEDLINE
DCOM- 20120618
LR  - 20220316
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 83
IP  - 1
DP  - 2012 May 1
TI  - Consolidative involved-node proton therapy for Stage IA-IIIB mediastinal Hodgkin 
      lymphoma: preliminary dosimetric outcomes from a Phase II study.
PG  - 260-7
LID - 10.1016/j.ijrobp.2011.06.1959 [doi]
AB  - PURPOSE: 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). 
      METHODS AND MATERIALS: 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. RESULTS: 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. CONCLUSIONS: 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.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Hoppe, Bradford S
AU  - Hoppe BS
AD  - University of Florida Proton Therapy Institute, Jacksonville, FL, USA. 
      bhoppe@floridaproton.org
FAU - Flampouri, Stella
AU  - Flampouri S
FAU - Su, Zhong
AU  - Su Z
FAU - Morris, Christopher G
AU  - Morris CG
FAU - Latif, Naeem
AU  - Latif N
FAU - Dang, Nam H
AU  - Dang NH
FAU - Lynch, James
AU  - Lynch J
FAU - Li, Zuofeng
AU  - Li Z
FAU - Mendenhall, Nancy P
AU  - Mendenhall NP
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Comparative Study
PT  - Journal Article
DEP - 20111017
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - 0 (Protons)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Breast/radiation effects
MH  - Esophagus/radiation effects
MH  - Female
MH  - Heart/radiation effects
MH  - Hodgkin Disease/pathology/*radiotherapy
MH  - Humans
MH  - Lung/radiation effects
MH  - Male
MH  - Mediastinal Neoplasms/pathology/*radiotherapy
MH  - Organs at Risk/*radiation effects
MH  - Prospective Studies
MH  - *Proton Therapy
MH  - Radiation Injuries/*prevention & control
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Conformal/adverse effects/methods
MH  - Radiotherapy, Intensity-Modulated/adverse effects/methods
MH  - Thyroid Gland/radiation effects
MH  - Tumor Burden
MH  - Young Adult
EDAT- 2011/10/22 06:00
MHDA- 2012/06/19 06:00
CRDT- 2011/10/22 06:00
PHST- 2011/03/08 00:00 [received]
PHST- 2011/05/23 00:00 [revised]
PHST- 2011/05/10 00:00 [accepted]
PHST- 2011/10/22 06:00 [entrez]
PHST- 2011/10/22 06:00 [pubmed]
PHST- 2012/06/19 06:00 [medline]
AID - S0360-3016(11)02825-2 [pii]
AID - 10.1016/j.ijrobp.2011.06.1959 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):260-7. doi: 
      10.1016/j.ijrobp.2011.06.1959. Epub 2011 Oct 17.