title: Dosimetric comparison of involved-field three-dimensional conformal photon radiotherapy and breast-sparing proton therapy for the treatment of Hodgkin's lymphoma in female pediatric patients.
abstract: OBJECTIVE
  To assess the potential reduction in breast dose for young girls with Hodgkin's lymphoma (HL) treated with breast-sparing proton therapy (BS-PT) as compared with three-dimensional conformal involved-field photon radiotherapy (3D-CRT).
  
  
  METHODS
  The Clarian Health Cancer Registry was queried for female pediatric patients with the diagnosis of HL who received radiotherapy at the Indiana University Simon Cancer Center during 2006-2009. The original CT simulation images were obtained, and 3D-CRT and BS-PT plans delivering 21 Gy or cobalt gray equivalent (CGE) in 14 fractions were created for each patient. Dose-volume histogram data were collected for both 3D-CRT and BS-PT plans and compared by paired t test for correlated samples.
  
  
  RESULTS
  The cancer registry provided 10 female patients with Ann Arbor Stage II HL, aged 10-18 years at the time of treatment. Both mean and maximum breast dose were significantly less with BS-PT compared with 3D-CRT: 0.95 CGE vs. 4.70 Gy (p < 0.001) and 21.07 CGE vs. 23.11 Gy (p < 0.001), respectively. The volume of breast receiving 1.0 Gy/CGE and 5.0 Gy/CGE was also significantly less with BS-PT, 194 cm(3) and 93 cm(3), respectively, compared with 790 cm(3) and 360 cm(3) with 3D-CRT (p = 0.009, 0.013).
  
  
  CONCLUSIONS
  Breast-sparing proton therapy has the potential to reduce unnecessary breast dose in young girls with HL by as much as 80% relative to involved-field 3D-CRT.
authors: Department of Radiation Oncology, Indiana University School of Medicine, Bloomington, IN 46202, USA. dandolin@iupui.edu
authors: David L
authors: DL
authors: Andolino
authors: Ted
authors: T
authors: Hoene
authors: Lu
authors: L
authors: Xiao
authors: Jeffrey
authors: J
authors: Buchsbaum
authors: Andrew L
authors: AL
authors: Chang
mesh_terms: D000293:Adolescent; D001940:Breast / Q000528:radiation effects*; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007196:Indiana; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D058958:Organs at Risk / Q000528:radiation effects; D017785:Photons / Q000009:adverse effects / Q000627:therapeutic use; D061766:Proton Therapy; D011522:Protons / Q000009:adverse effects; D011832:Radiation Injuries / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012042:Registries / Q000706:statistics & numerical data
chemical_list: D011522:Protons