title: Proton Therapy for Pediatric Hodgkin Lymphoma.
abstract: Compared to X-ray radiation therapy, proton therapy (PT) reduces the radiation dose to organs at risk, which is expected to translate into fewer second cancers and less cardiac morbidity decades after treatment. The Children's Oncology Group high-risk pediatric Hodgkin lymphoma (PHL) protocol, AHOD1331, allows the use of PT, yet limited data exist on the use of PT in PHL.
  
  
  
  Between 2010 and 2014, 22 pediatric patients were treated with PT for PHL at our institution: 7 intermediate-risk patients, 11 high-risk patients, and 4 relapsed patients. The patients' age ranged from 6 to 18 years old. Median follow-up was 36 months. All patients received chemotherapy before PT.
  
  
  
  The 2-year and 3-year overall survival rates were both 94%, and the progression-free survival rate was 86%. Recurrences occurred in three high-risk patients: one isolated in-field cervical lymph node and two in-field and out-of-field. All recurrences occurred within 5 months of completing PT. No PT-related grade 3 or higher acute or late complications were observed.
  
  
  
  PT for PHL showed no short-term severe toxicity and yields similar short-term control to recently published large multi-institutional clinical trials.
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, Florida.|University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Justin
authors.initials: J
authors.lastname: Wray
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, Florida.|University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Stella
authors.initials: S
authors.lastname: Flampouri
authors.affiliation: Division of Hematology and Oncology, University of Florida Department of Pediatrics, Gainesville, Florida.
authors.forename: William
authors.initials: W
authors.lastname: Slayton
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Nemours Children's Clinic, Jacksonville, Florida.
authors.forename: Michael
authors.initials: M
authors.lastname: Joyce
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Nemours Children's Clinic, Jacksonville, Florida.
authors.forename: Eric
authors.initials: E
authors.lastname: Sandler
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, Florida.|University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.affiliation: University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Zuofeng
authors.initials: Z
authors.lastname: Li
authors.affiliation: University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Indelicato
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, Florida.|University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Mendenhall
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, Florida.|University of Florida Health Proton Therapy Institute, Jacksonville, Florida.
authors.forename: Bradford S
authors.initials: BS
authors.lastname: Hoppe
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D061766:Proton Therapy / Q000009:adverse effects; D011880:Radiotherapy Planning, Computer-Assisted; D012008:Recurrence; D014057:Tomography, X-Ray Computed
keywords: Hodgkin lymphoma; chemotherapy; lymphoma; proton therapy