Abstract
IntroductionEffective dose to circulating immune cells (EDIC) is associated with survival in lung and esophageal cancer patients. This study aimed to evaluate the benefit of intensity modulated proton therapy (IMPT) for EDIC reduction compared with volumetric modulated arc therapy (VMAT) in mediastinal Hodgkin lymphoma (mHL) patients. Materials and MethodsTen consecutive mHL patients treated with involved-site IMPT after frontline chemotherapy were included. Mean dose to the heart (MHD), lung (MLD), and liver (MlD) and integral dose to the body (ITD) were obtained, and we calculated EDIC based on these variables. EDIC was compared between IMPT and VMAT schedules. ResultsThe median EDIC was reduced from 1.93 Gy [range: 1.31-3.87] with VMAT to 1.08 Gy [0.53-2.09] with IMPT (p<0.01). Integral dose reduction was the main driver of EDIC reduction with IMPT, followed by lung sparing. ConclusionsIMPT significantly reduced EDIC in mHL patients undergoing consolidation involved-site radiotherapy. Integral dose reduction combined with improved lung sparing was the main driver of EDIC reduction with IMPT.
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