S523
Clinical - Haemotology
ESTRO 2026
included nine pediatric patients and thirty-eight adults. Twenty-four patients - six pediatric and eighteen adults - presented with bulky disease at diagnosis. Only one patient, diagnosed with stage IA nodal marginal zone B-cell lymphoma, didn’t receive chemotherapy before proton therapy. All patients were treated using breath-hold (BH) technique in supine position using the Active Breathing Coordinator (ABC - ElektaTM) system, with beam delivery triggered by deep inspiration. Technical feasibility and dosimetric aspects of this approach were previously evaluated at our center, showing promising results (Ref.1) Prescribed doses are reported in Table 1.
mediastinal irradiation. three had additional axillary irradiation. Radiotherapy was delivered to a dose of 30Gy in 15 fractions. Only three patients received an additional boost up to 36Gy.The mean heart dose was 7.42 Gy (range 2.5–17.11 Gy). The sinoatrialnode (SAN) received a mean dose of 15.68 Gy (range 3.81–35.7 Gy) and a Dmax of 22.78 Gy (range 5.41–38.3 Gy). The atrioventricularnode (AVN) received a mean dose of 6.04 Gy (range 1.41–15.48 Gy) and a Dmax of 9.5 Gy (range 1.75–22.23 Gy). Conclusion: Our dosimetric study reveals significant CCS exposure
during mediastinal IMRT/VMAT, potentially contributing to late arrhythmias in Hodgkin
Lymphoma survivors. These findings highlight the importance of including the CCS among organs at risk in treatment planning and future prospective studies. References: https://www.sciencedirect.com/science/article/pii/S187 9850021000461 Manuscript_4e43e815ce478bdaa604fb7f458e4a76 Keywords: Hodgkin lymphoma, Dosimetry, heart
Results: The treatment was well tolerated, with no need for interruptions. Acute toxicities occurred in nearly all treated patients (46) and were limited to G1–2 events. Grade 2 events represented 13.2% of all acute toxicities and the most frequent were pharyngodynia and radiodermatitis.Late toxicities were generally mild, with no grade ≥ 3 events observed. Among patients with at least six months of follow-up, 26.2% of them reported one or more of the following: G1 fatigue, G1 palpitations, G1 exertional dyspnea, and G2 thyroid dysfunction (4.7%). The latter one was successfully managed with hormonal replacement therapy. No cardiac events or second radiation-induced tumors were recorded so far. At the median follow-up of 36.9 months (range 0.7-90.5 months) the OS and the PFS were 100%. Oncological outcomes were excellent, with all patients alive and in complete remission after primary therapy. Data on OS and PFS are shown in Figure 1.
Digital Poster 4795
Intensity Modulated Proton Therapy with active breath hold technique in mediastinal Hodgkin and non-Hodgkin lymphoma: a single-institution experience Sara Saufi 1 , Daniele Scartoni 2 , Barbara Rombi 2 , Elena Zanella 2 , Francesco Fracchiolla 3,4 , Roberto Righetto 3 , Stefano Lorentini 3 , Frank Lohr 3 1 School of Radiation Oncology, University Milano- Bicocca, Monza, Italy. 2 Proton Therapy Department, Trento Hospital Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy. 3 UO Fisica Sanitaria, Trento Hospital Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy. 4 Faculty of Medicine, University of Bern, Bern, Switzerland Purpose/Objective: Proton therapy (PT) is an advanced radiotherapy technique characterized by specific physical properties. In mediastinal lymphoma, PT may offer a dosimetric advantage, allowing optimal tumor control while decreasing the risk of late toxicities in patients with long-term survival expectancy. We report clinical outcomes at our centre, including acute and late toxicities, Progression-Free Survival (PFS) and Overall Survival (OS). Material/Methods: From April 2018 to October 2025, 47 patients with mediastinal lymphoma were treated with Intensity Modulated Proton Therapy (IMPT): 74.5% were diagnosed with Hodgkin lymphoma (HL) and 25.5% with non-Hodgkin lymphoma (NHL). The cohort
Made with FlippingBook - Share PDF online