Advantage of proton-radiotherapy for pediatric patients and adolescents with Hodgkin’s disease

a Areas in which the VMAT / IMRT plans will deliver more dose to organs at risk or the body compartment. b Areas in which the proton plan delivers more dose to organs at risk or the body compartment compared to the VMAT / IMRT plant

“Proton therapy for mediastinal lymphoma reduces significantly the dose to organs at risk and the integral body dose. It might lead to reduced late toxicities and secondary malignancies. This is especially important for children and young adults. It should be considered for both sexes, as both male and female patients benefit from the unique features of particle irradiation. Whenever proton for mediastinal lymphoma is not available or technical not feasible the alternative photon concepts have to be chosen carefully. Depending on the used technique certain organs at risk, i.e. the breasts in young females, can be spared with higher priority. However, with all photon techniques that comes at the cost of higher doses to the other organs at risk. If available, proton therapy should be the standard pattern of care for mediastinal lymphoma for young adults below 30 years of age, no matter if male or female.”

S. Lautenschlaeger, G. Iancu, V. Flatten, K. Baumann, M. Thiemer, C. Dumke, K. Zink, H. Hauswald, D. Vordermark, C. Mauz-Körholz, R. Engenhart-Cabillic & F. Eberle
Radiation Oncology volume 14, Article number: 157 (2019)

Treatment of Early FL More Effective With PET-Staging and Contemporary RT

Andrea Blevins Primeau, PhD, MBA

The results of this study suggest that upfront, early-stage follicular lymphoma (FL) treatment with RT is safe and results in excellent outcomes. Importantly, these results are of “more than 500 patients, all of whom have been treated in a contemporary fashion with PET staging,” Dr Hoppe said, highlighting that it is typically challenging to evaluate a large number of patients because FL is so uncommon. 

Dr Hoppe recommends that oncologists and hematologists with a patient diagnosed with FL who has been PET-staged with stage I or stage II disease seek the opinion of a radiation oncologist. “That doesn’t commit the patient to being treated by a radiation oncologist, but you can properly inform the patient [of] the potential risks and benefits of treatment.” He further highlighted that “this gives the patient the best opportunity to participate in making an informed decision as to what the treatment should be.”