Rationale for and Preliminary Results of Proton Beam Therapy for Mediastinal Lymphoma

Dosimetric Correlate of Cardiac-Specific Survival Among Patients Undergoing Coronary Artery Stenting After Thoracic Radiotherapy for Cancer

“…The use of proton therapy can significantly decrease the radiation dose to both the lungs and the heart and may result in improved cardiacspecific survival and improved long-term side effect profiles from cancer therapy in thoracic and breast cancers. [16][17][18] The higher rate of MACEs among diabetic patients treated with RT after PCI in our cohort is consistent with data suggesting similarly worse long-term cardiac outcomes among diabetic patients after PCI not treated with RT. 19 Diabetic patients are thought to have a higher incidence of atherosclerosis, which is associated with worse long-term survival and higher rates of revascularization.…”

Hodgkin Lymphoma Version 1.2017, NCCN Clinical Practice Guidelines in Oncology

“…Preliminary results from singleinstitution studies have shown that significant dose reduction to organs at risk (OARs; eg, lungs, heart, breasts, kidneys, spinal cord, esophagus, carotid artery, bone marrow, stomach, muscle, soft tissue, and salivary glands) can be achieved with advanced RT planning and delivery techniques such as 4-dimensional CT simulation, intensity-modulated RT, image-guided RT, respiratory gating, or deep inspiration breathhold. 26,27 These techniques offer significant and clinically relevant advantages in specific instances to spare OARs and decrease the risk of normal tissue damage and late effects without compromising the primary goal of local tumor control. [28][29][30][31][32][33][34] Randomized prospective studies to test these concepts are unlikely to be conducted because these techniques are designed to decrease late effects, which usually develop ≥10 years after completion of treatment.…”

Hodgkin Lymphoma, Version 2.2015

“…Preliminary results from single-institution studies have shown that significant dose reduction to organs at risk (eg, lungs, heart, breasts, kidneys, spinal cord, esophagus, carotid artery, bone marrow, stomach, muscle, soft tissue, salivary glands) can be achieved with advanced RT planning and delivery techniques, such as 4-dimensional CT simulation, intensity-modulated RT, image-guided RT, respiratory gating, or deep inspiration breath hold. 31,32 These techniques offer significant and clinically relevant advantages in specific instances to spare organs at risk and decrease the risk of normal tissue damage and late effects without compromising the primary goal of local tumor control. 33–39 …”