The impact of protocol assignment for older adolescents with Hodgkin Lymphoma
Background and Purpose: Hodgkin Lymphoma (HL) treatment has evolved to reduce or avoid radiotherapy (RT) dose and volume and minimize the potential for late effects. Some older adolescents are treated on adult protocols. The purpose of this study is to examine the protocol assignment of older adoles...
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2014-11-01
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doaj-7ccf5e5373774354b3cd584053248b5b2020-11-24T21:01:11ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2014-11-01410.3389/fonc.2014.00317110328The impact of protocol assignment for older adolescents with Hodgkin LymphomaRichard S Pieters0Henry eWagner1Stephen eBaker2Karen eMorano3Kenneth eUlin4Kenneth eUlin5Maria eCicchetti6Maria eCicchetti7Maryann eBishop-Jodoin8Thomas J FitzGerald9Thomas J FitzGerald10University of Massachusetts Medical SchoolPennsylvania State University- Hershey Medical CenterUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolUniversity of Massachusetts Medical SchoolBackground and Purpose: Hodgkin Lymphoma (HL) treatment has evolved to reduce or avoid radiotherapy (RT) dose and volume and minimize the potential for late effects. Some older adolescents are treated on adult protocols. The purpose of this study is to examine the protocol assignment of older adolescents and its impact on radiation dose to relevant thoracic structures.Material and Methods: Cooperative group data were reviewed and 12 adolescents were randomly selected from a pediatric HL protocol. Treatment plans were generated per one pediatric and two adult protocols. Dose volume histograms for heart, lung and breast allowed comparison of radiation dose to these sites across these 3 protocols.Results: A total of 15.2% of adolescents were treated on adult HL protocols and received significantly higher radiation dosage to heart and lung compared to pediatric HL protocols. Adolescents treated on either pediatric or adult protocols received similar RT dose to breast.Conclusions: Older adolescents treated on adult HL protocols received higher RT dose to thoracic structures except breast. Level of nodal involvement may impact overall RT dose to breast. The impact of varying field design and RT dose on survival, local, and late effects needs further study for this vulnerable age group.http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00317/fullRadiotherapyclinical trialsadolescentsyoung adultsHodgkin lymphoma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Richard S Pieters Henry eWagner Stephen eBaker Karen eMorano Kenneth eUlin Kenneth eUlin Maria eCicchetti Maria eCicchetti Maryann eBishop-Jodoin Thomas J FitzGerald Thomas J FitzGerald |
spellingShingle |
Richard S Pieters Henry eWagner Stephen eBaker Karen eMorano Kenneth eUlin Kenneth eUlin Maria eCicchetti Maria eCicchetti Maryann eBishop-Jodoin Thomas J FitzGerald Thomas J FitzGerald The impact of protocol assignment for older adolescents with Hodgkin Lymphoma Frontiers in Oncology Radiotherapy clinical trials adolescents young adults Hodgkin lymphoma |
author_facet |
Richard S Pieters Henry eWagner Stephen eBaker Karen eMorano Kenneth eUlin Kenneth eUlin Maria eCicchetti Maria eCicchetti Maryann eBishop-Jodoin Thomas J FitzGerald Thomas J FitzGerald |
author_sort |
Richard S Pieters |
title |
The impact of protocol assignment for older adolescents with Hodgkin Lymphoma |
title_short |
The impact of protocol assignment for older adolescents with Hodgkin Lymphoma |
title_full |
The impact of protocol assignment for older adolescents with Hodgkin Lymphoma |
title_fullStr |
The impact of protocol assignment for older adolescents with Hodgkin Lymphoma |
title_full_unstemmed |
The impact of protocol assignment for older adolescents with Hodgkin Lymphoma |
title_sort |
impact of protocol assignment for older adolescents with hodgkin lymphoma |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2014-11-01 |
description |
Background and Purpose: Hodgkin Lymphoma (HL) treatment has evolved to reduce or avoid radiotherapy (RT) dose and volume and minimize the potential for late effects. Some older adolescents are treated on adult protocols. The purpose of this study is to examine the protocol assignment of older adolescents and its impact on radiation dose to relevant thoracic structures.Material and Methods: Cooperative group data were reviewed and 12 adolescents were randomly selected from a pediatric HL protocol. Treatment plans were generated per one pediatric and two adult protocols. Dose volume histograms for heart, lung and breast allowed comparison of radiation dose to these sites across these 3 protocols.Results: A total of 15.2% of adolescents were treated on adult HL protocols and received significantly higher radiation dosage to heart and lung compared to pediatric HL protocols. Adolescents treated on either pediatric or adult protocols received similar RT dose to breast.Conclusions: Older adolescents treated on adult HL protocols received higher RT dose to thoracic structures except breast. Level of nodal involvement may impact overall RT dose to breast. The impact of varying field design and RT dose on survival, local, and late effects needs further study for this vulnerable age group. |
topic |
Radiotherapy clinical trials adolescents young adults Hodgkin lymphoma |
url |
http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00317/full |
work_keys_str_mv |
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