Loap Pierre, De Marzi Ludovic, Decroocq Justine, Birsen Rudy, Johnson Natacha, Deau Fischer Benedicte, Bouscary Didier, Kirova Youlia
Department of Radiation Oncology, Institut Curie, Paris, France.
Laboratoire d'Imagerie Translationnelle en Oncologie (LITO), Institut Curie, Université PSL, Université Paris-Saclay, Inserm U1288, Orsay, France.
Int J Part Ther. 2024 Jun 20;13:100110. doi: 10.1016/j.ijpt.2024.100110. eCollection 2024 Sep.
Effective 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.
Ten consecutive mHL patients treated with involved-site IMPT after frontline chemotherapy were included. The mean dose to the heart, lung, and liver and the integral dose to the body were obtained, and we calculated EDIC based on these variables. The effective dose to circulating immune cells was compared between IMPT and VMAT schedules.
The 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 ( < .01). Integral dose reduction was the main driver of EDIC reduction with IMPT, followed by lung sparing.
Intensity-modulated proton therapy significantly reduced EDIC in mHL patients undergoing consolidation involved-site radiation therapy. Integral dose reduction combined with improved lung sparing was the main driver of EDIC reduction with IMPT.
循环免疫细胞有效剂量（EDIC）与肺癌和食管癌患者的生存率相关。本研究旨在评估调强质子治疗（IMPT）相较于容积调强弧形放疗（VMAT）在纵隔霍奇金淋巴瘤（mHL）患者中降低EDIC的益处。
纳入10例一线化疗后接受累及野IMPT治疗的连续mHL患者。获取心脏、肺和肝脏的平均剂量以及身体的积分剂量，并基于这些变量计算EDIC。比较IMPT和VMAT方案下循环免疫细胞的有效剂量。
EDIC中位数从VMAT时的1.93 Gy（范围：1.31 - 3.87）降至IMPT时的1.08 Gy（0.53 - 2.09）（<0.01）。积分剂量降低是IMPT降低EDIC的主要驱动因素，其次是肺保护。
调强质子治疗显著降低了接受巩固性累及野放疗的mHL患者的EDIC。积分剂量降低与更好的肺保护相结合是IMPT降低EDIC的主要驱动因素。
