Involved-node proton therapy in combined modality therapy for Hodgkin lymphoma: results of a phase 2 study.

摘要: Purpose This study describes the early clinical outcomes of a prospective phase 2 consolidative involved-node proton therapy (INPT) as component combined-mode in patients with stages I to III Hodgkin lymphoma (HL) mediastinal involvement. Methods and Materials Between September 2009 June 2013, 15 newly diagnosed HL received INPT after completing chemotherapy an institutional review board-approved protocol comparing dosimetric impact PT those three-dimensional conformal radiation (3DCRT) intensity modulated RT. Based on 18 F-Fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) response, 5 children 25.5 cobalt Gy equivalent (CGE) receiving 4 cycles Adriamycin, Bleomycin, Vincristine, Etoposide, Prednisone, Cyclophosphamide or adriamycin, methotrexate, Prednisone chemotherapy, 10 adults 30.6 39.6 CGE 3 6 Bleomycine, Vinblastine, Dacarbazine. Patients were routinely evaluated for toxicity during treatment, using Common Terminology Criteria Adverse Events, version 3.0, relapse by physical examination routine imaging. Relapse-free survival (RFS) event-free (EFS) rates calculated Kaplan-Meier method from time diagnosis. Results The median follow-up was 37 months (range, 26-55). Two events occurred follow-up: 1 (inside outside targeted field) transformation into primary large B cell lymphoma. 3-year RFS rate 93%, EFS 87%. No acute late grade nonhematologic toxicities observed. Conclusions Although decades will be needed realize likely benefit reducing risk radiation-induced effects, following is well-tolerated, disease similar conventional photon therapy.