Current Situation of Proton Therapy for Hodgkin Lymphoma: From Expectations to Evidence.
Pierre LoapAlfredo MirandolaLudovic de MarziRemi DendaleAlberto IannalfiViviana VitoloAmelia BarcelliniAndrea Riccardo FilippiBarbara Alicja Jereczek-FossaYoulia KirovaEster OrlandiPublished in: Cancers (2021)
Consolidative radiation therapy (RT) is of prime importance for early-stage Hodgkin lymphoma (HL) management since it significantly increases progression-free survival (PFS). Nevertheless, first-generation techniques, relying on large irradiation fields, delivered significant radiation doses to critical organs-at-risk (OARs, such as the heart, to the lung or the breasts) when treating mediastinal HL; consequently, secondary cancers, and cardiac and lung toxicity were substantially increased. Fortunately, HL RT has drastically evolved and, nowadays, state-of-the-art RT techniques efficiently spare critical organs-at-risks without altering local control or overall survival. Recently, proton therapy has been evaluated for mediastinal HL treatment, due to its possibility to significantly reduce integral dose to OARs, which is expected to limit second neoplasm risk and reduce late toxicity. Nevertheless, clinical experience for this recent technique is still limited worldwide. Based on current literature, this critical review aims to examine the current practice of proton therapy for mediastinal HL irradiation.
Keyphrases
- hodgkin lymphoma
- free survival
- lymph node
- early stage
- radiation therapy
- oxidative stress
- ultrasound guided
- radiation induced
- systematic review
- primary care
- healthcare
- heart failure
- squamous cell carcinoma
- left ventricular
- risk assessment
- sentinel lymph node
- young adults
- quality improvement
- neoadjuvant chemotherapy
- smoking cessation
- combination therapy