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Proton therapy to the subdiaphragmatic region in the management of patients with Hodgkin lymphoma.
[hodgkin lymphoma, classical]
Twelve
consecutive
patients
with
classical
Hodgkin
lymphoma
(
HL
)
involving
diaphragmatic
or
subdiaphragmatic
regions
were
treated
on
an
institutional
review
board-approved
outcomes
tracking
protocol
.
All
patients
underwent
treatment
with
proton
therapy
following
chemotherapy
and
had
comparative
three
-dimensional
conformal
photon
radiotherapy
(
3
DCRT
)
and
intensity-modulated
radiotherapy
(
IMRT
)
plans
to
evaluate
differences
in
dose
to
organs
at
risk
(
OARs
)
.
Among
the
cohort
,
stomach
doses
with
3
DCRT
,
IMRT
and
proton
therapy
were
21
Gy
(
median
)
,
14
Gy
and
6
Gy
,
respectively
.
Median
dose
reductions
with
proton
therapy
compared
with
3
DCRT
and
IMRT
were
13
Gy
(
p
=
0
.
0022
)
and
8
Gy
(
p
=
0
.
0022
)
for
the
stomach
.
Additionally
,
there
was
significant
dose
reduction
using
proton
therapy
for
the
liver
,
pancreas
,
bowel
,
left
kidney
and
right
kidney
.
Proton
therapy
reduces
the
dose
to
the
stomach
,
liver
,
pancreas
,
small
bowel
and
kidneys
compared
with
3
DCRT
or
IMRT
in
patients
with
HL
requiring
abdominal
radiotherapy
.
These
dose
reductions
are
expected
to
translate
into
lower
risks
of
secondary
cancers
and
other
late
toxicities
in
survivors
of
HL
.
Diseases
Validation
Diseases presenting
"secondary cancers"
symptom
hodgkin lymphoma, classical
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