A new study from Children’s Hospital of Philadelphia (CHOP) showed promising results for Pediatric Hodgkin Lymphoma (pHL) patients who underwent proton therapy to treat their disease in rare regions located below the diaphragm, such as the abdomen and pelvis. The study highlights the advantages of proton therapy over conventional photon radiotherapy, demonstrating fewer side effects and better protection for critical organs. It was published recently in the journal Pediatric Blood and Cancer.
Pediatric Hodgkin lymphoma, a cancer that develops in the lymphatic system, but which is highly curable, is rare but among the most common cancers in adolescents in the United States. Currently, long-term survival exceeds 90%. The typical approach to treatment is combination chemotherapy, with photon radiotherapy based on personalized factors. However, doctors have expressed concern about the side effects of photon radiotherapy, which uses x-rays or gamma rays to treat cancer but can also hurt nearby healthy tissues. Proton therapy uses a beam of high-energy protons to more precisely target cancer, which reduces the likelihood of damage to surrounding areas. This led study researchers to take a closer look at the potential benefits of using proton therapy in regions below the diaphragm.
“Our findings underscore the potential of proton therapy as a safer, more targeted option for treating pediatric Hodgkin lymphoma, particularly in patients with cancer below the diaphragm,” said Michael LaRivere, MD, an attending physician with the Pediatric Proton Therapy Center at Children’s Hospital of Philadelphia. “This study represents an important step forward in improving long-term, quality of life outcomes for young patients with this rare form of cancer.”
In the study, researchers reviewed 21 pediatric patients treated between 2011 and 2022, all of whom received proton therapy targeting regions below the diaphragm. The patients ranged in age from 4 to 22 years old and had a median of five years follow-up after treatment. Most study participants were newly diagnosed with intermediate-risk pHL, which is more advanced than early-stage but not severe. The study also included patients with relapsed Hodgkin lymphoma.
Researchers found that proton therapy significantly lowered radiation exposure to vital organs such as the bowels, stomach, liver, kidneys and spleen compared with traditional photon radiotherapy, which may reduce long-term damage to healthy areas of the body. The findings also showed that proton therapy yielded few side effects. In fact, no patients experienced severe side effects, with the most common mild side effects including temporary fatigue (59%) and temporarily reduced hunger and eating (36%).
The authors also noted that patients did not experience secondary malignancies or organ damage, which often occur with traditional radiotherapy treatments, though they note that long-term follow-up is needed as these side effects can take time to develop.
Researchers noted it was significant that patients did not experience local or marginal cancer reoccurrence after treatment. Two patients did experience disease progression; however, both were treated with additional therapies and are currently cancer-free. For two female patients, whose ovaries were in the radiation field, proton therapy delivered substantially less radiation than photon radiotherapy, which researchers hope will help preserve fertility. As a result of this study, ongoing research is looking at potential advantages of proton therapy in adult patients with lymphoma below the diaphragm.
Jiang et al. “Outcomes of proton therapy to infradiaphragmatic sites in pediatric patients with Hodgkin lymphoma.” Pediatric Blood and Cancer. Online, September 12, 2024. DOI: 10.1002/pbc.31290.
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A new study from Children’s Hospital of Philadelphia (CHOP) showed promising results for Pediatric Hodgkin Lymphoma (pHL) patients who underwent proton therapy to treat their disease in rare regions located below the diaphragm, such as the abdomen and pelvis. The study highlights the advantages of proton therapy over conventional photon radiotherapy, demonstrating fewer side effects and better protection for critical organs. It was published recently in the journal Pediatric Blood and Cancer.
Pediatric Hodgkin lymphoma, a cancer that develops in the lymphatic system, but which is highly curable, is rare but among the most common cancers in adolescents in the United States. Currently, long-term survival exceeds 90%. The typical approach to treatment is combination chemotherapy, with photon radiotherapy based on personalized factors. However, doctors have expressed concern about the side effects of photon radiotherapy, which uses x-rays or gamma rays to treat cancer but can also hurt nearby healthy tissues. Proton therapy uses a beam of high-energy protons to more precisely target cancer, which reduces the likelihood of damage to surrounding areas. This led study researchers to take a closer look at the potential benefits of using proton therapy in regions below the diaphragm.
“Our findings underscore the potential of proton therapy as a safer, more targeted option for treating pediatric Hodgkin lymphoma, particularly in patients with cancer below the diaphragm,” said Michael LaRivere, MD, an attending physician with the Pediatric Proton Therapy Center at Children’s Hospital of Philadelphia. “This study represents an important step forward in improving long-term, quality of life outcomes for young patients with this rare form of cancer.”
In the study, researchers reviewed 21 pediatric patients treated between 2011 and 2022, all of whom received proton therapy targeting regions below the diaphragm. The patients ranged in age from 4 to 22 years old and had a median of five years follow-up after treatment. Most study participants were newly diagnosed with intermediate-risk pHL, which is more advanced than early-stage but not severe. The study also included patients with relapsed Hodgkin lymphoma.
Researchers found that proton therapy significantly lowered radiation exposure to vital organs such as the bowels, stomach, liver, kidneys and spleen compared with traditional photon radiotherapy, which may reduce long-term damage to healthy areas of the body. The findings also showed that proton therapy yielded few side effects. In fact, no patients experienced severe side effects, with the most common mild side effects including temporary fatigue (59%) and temporarily reduced hunger and eating (36%).
The authors also noted that patients did not experience secondary malignancies or organ damage, which often occur with traditional radiotherapy treatments, though they note that long-term follow-up is needed as these side effects can take time to develop.
Researchers noted it was significant that patients did not experience local or marginal cancer reoccurrence after treatment. Two patients did experience disease progression; however, both were treated with additional therapies and are currently cancer-free. For two female patients, whose ovaries were in the radiation field, proton therapy delivered substantially less radiation than photon radiotherapy, which researchers hope will help preserve fertility. As a result of this study, ongoing research is looking at potential advantages of proton therapy in adult patients with lymphoma below the diaphragm.
Jiang et al. “Outcomes of proton therapy to infradiaphragmatic sites in pediatric patients with Hodgkin lymphoma.” Pediatric Blood and Cancer. Online, September 12, 2024. DOI: 10.1002/pbc.31290.
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