Proton Therapy for Hodgkin Lymphoma

NCT ID: NCT00850200

Last Updated: 2019-01-31

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-08-31

Study Completion Date

2018-01-09

Brief Summary

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The purpose of this study is to reduce the risk of radiation related side effects and complications by treating with radiation (protons or photons) that exposes less of normal organs to low dose radiation.

Detailed Description

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3 treatment plans will be created to deliver between a total of 21-39.6 Gray (Gy)/Centigray Equivalents (CGE) to the planning target volume (PTV).

1. Proton Plan
2. Conventional Plan
3. Intensity Modulated Radiotherapy (IMRT) Plan

The patient will then receive the radiation modality with the lowest percentage of the body receiving 4 Gy (V4Gy/CGE)

Conditions

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Hodgkin Lymphoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Proton Radiation Plan

Group Type EXPERIMENTAL

Proton Radiation Plan

Intervention Type RADIATION

Between 21-39.6 Gy/CGE to the PTV

Conventional Photon Radiation Plan

Group Type ACTIVE_COMPARATOR

Conventional Photon Radiation Plan

Intervention Type RADIATION

Between 21-39.6 Gy/CGE to the PTV

Intensity Modulated Radiation Plan

Group Type ACTIVE_COMPARATOR

Intensity Modulated Radiation Plan

Intervention Type RADIATION

Between 21-39.6 Gy/CGE to the PTV

Interventions

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Proton Radiation Plan

Between 21-39.6 Gy/CGE to the PTV

Intervention Type RADIATION

Conventional Photon Radiation Plan

Between 21-39.6 Gy/CGE to the PTV

Intervention Type RADIATION

Intensity Modulated Radiation Plan

Between 21-39.6 Gy/CGE to the PTV

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Confirmed "classic" Hodgkin lymphoma.
* Completed chemotherapy.

Exclusion Criteria

* Prior radiotherapy.
* Prior or concurrent cancer other than non-melanomatous skin cancer.
Minimum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bradford S Hoppe, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of Florida Proton Therapy Institute

Locations

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University of Florida Proton Therapy Institute

Jacksonville, Florida, United States

Site Status

Countries

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United States

References

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Bonadonna G, Bonfante V, Viviani S, Di Russo A, Villani F, Valagussa P. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results. J Clin Oncol. 2004 Jul 15;22(14):2835-41. doi: 10.1200/JCO.2004.12.170. Epub 2004 Jun 15.

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Horning SJ, Hoppe RT, Breslin S, Bartlett NL, Brown BW, Rosenberg SA. Stanford V and radiotherapy for locally extensive and advanced Hodgkin's disease: mature results of a prospective clinical trial. J Clin Oncol. 2002 Feb 1;20(3):630-7. doi: 10.1200/JCO.2002.20.3.630.

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Straus DJ, Portlock CS, Qin J, Myers J, Zelenetz AD, Moskowitz C, Noy A, Goy A, Yahalom J. Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease. Blood. 2004 Dec 1;104(12):3483-9. doi: 10.1182/blood-2004-04-1311. Epub 2004 Aug 17.

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van Leeuwen FE, Klokman WJ, Stovall M, Dahler EC, van't Veer MB, Noordijk EM, Crommelin MA, Aleman BM, Broeks A, Gospodarowicz M, Travis LB, Russell NS. Roles of radiation dose, chemotherapy, and hormonal factors in breast cancer following Hodgkin's disease. J Natl Cancer Inst. 2003 Jul 2;95(13):971-80. doi: 10.1093/jnci/95.13.971.

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Ng AK, Bernardo MV, Weller E, Backstrand K, Silver B, Marcus KC, Tarbell NJ, Stevenson MA, Friedberg JW, Mauch PM. Second malignancy after Hodgkin disease treated with radiation therapy with or without chemotherapy: long-term risks and risk factors. Blood. 2002 Sep 15;100(6):1989-96. doi: 10.1182/blood-2002-02-0634.

Reference Type BACKGROUND
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Behringer K, Josting A, Schiller P, Eich HT, Bredenfeld H, Diehl V, Engert A; German Hodgkin Lymphoma Study Group. Solid tumors in patients treated for Hodgkin's disease: a report from the German Hodgkin Lymphoma Study Group. Ann Oncol. 2004 Jul;15(7):1079-85. doi: 10.1093/annonc/mdh273.

Reference Type BACKGROUND
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Campbell BA, Voss N, Pickles T, Morris J, Gascoyne RD, Savage KJ, Connors JM. Involved-nodal radiation therapy as a component of combination therapy for limited-stage Hodgkin's lymphoma: a question of field size. J Clin Oncol. 2008 Nov 10;26(32):5170-4. doi: 10.1200/JCO.2007.15.1001. Epub 2008 Oct 6.

Reference Type BACKGROUND
PMID: 18838714 (View on PubMed)

Girinsky T, Pichenot C, Beaudre A, Ghalibafian M, Lefkopoulos D. Is intensity-modulated radiotherapy better than conventional radiation treatment and three-dimensional conformal radiotherapy for mediastinal masses in patients with Hodgkin's disease, and is there a role for beam orientation optimization and dose constraints assigned to virtual volumes? Int J Radiat Oncol Biol Phys. 2006 Jan 1;64(1):218-26. doi: 10.1016/j.ijrobp.2005.06.004. Epub 2005 Sep 19.

Reference Type BACKGROUND
PMID: 16169675 (View on PubMed)

Goodman KA, Toner S, Hunt M, Wu EJ, Yahalom J. Intensity-modulated radiotherapy for lymphoma involving the mediastinum. Int J Radiat Oncol Biol Phys. 2005 May 1;62(1):198-206. doi: 10.1016/j.ijrobp.2004.08.048.

Reference Type BACKGROUND
PMID: 15850922 (View on PubMed)

Nieder C, Schill S, Kneschaurek P, Molls M. Influence of different treatment techniques on radiation dose to the LAD coronary artery. Radiat Oncol. 2007 Jun 5;2:20. doi: 10.1186/1748-717X-2-20.

Reference Type BACKGROUND
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Schneider U, Lomax A, Lombriser N. Comparative risk assessment of secondary cancer incidence after treatment of Hodgkin's disease with photon and proton radiation. Radiat Res. 2000 Oct;154(4):382-8. doi: 10.1667/0033-7587(2000)154[0382:craosc]2.0.co;2.

Reference Type BACKGROUND
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Sigurdson AJ, Ronckers CM, Mertens AC, Stovall M, Smith SA, Liu Y, Berkow RL, Hammond S, Neglia JP, Meadows AT, Sklar CA, Robison LL, Inskip PD. Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): a nested case-control study. Lancet. 2005 Jun 11-17;365(9476):2014-23. doi: 10.1016/S0140-6736(05)66695-0.

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Nieder C, Schill S, Kneschaurek P, Molls M. Comparison of three different mediastinal radiotherapy techniques in female patients: Impact on heart sparing and dose to the breasts. Radiother Oncol. 2007 Mar;82(3):301-7. doi: 10.1016/j.radonc.2006.10.015. Epub 2006 Dec 6.

Reference Type BACKGROUND
PMID: 17156873 (View on PubMed)

Travis LB, Gospodarowicz M, Curtis RE, Clarke EA, Andersson M, Glimelius B, Joensuu T, Lynch CF, van Leeuwen FE, Holowaty E, Storm H, Glimelius I, Pukkala E, Stovall M, Fraumeni JF Jr, Boice JD Jr, Gilbert E. Lung cancer following chemotherapy and radiotherapy for Hodgkin's disease. J Natl Cancer Inst. 2002 Feb 6;94(3):182-92. doi: 10.1093/jnci/94.3.182.

Reference Type BACKGROUND
PMID: 11830608 (View on PubMed)

Travis LB, Hill DA, Dores GM, Gospodarowicz M, van Leeuwen FE, Holowaty E, Glimelius B, Andersson M, Wiklund T, Lynch CF, Van't Veer MB, Glimelius I, Storm H, Pukkala E, Stovall M, Curtis R, Boice JD Jr, Gilbert E. Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA. 2003 Jul 23;290(4):465-75. doi: 10.1001/jama.290.4.465.

Reference Type BACKGROUND
PMID: 12876089 (View on PubMed)

Graham MV, Purdy JA, Emami B, Harms W, Bosch W, Lockett MA, Perez CA. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys. 1999 Sep 1;45(2):323-9. doi: 10.1016/s0360-3016(99)00183-2.

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Tsujino K, Hirota S, Endo M, Obayashi K, Kotani Y, Satouchi M, Kado T, Takada Y. Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2003 Jan 1;55(1):110-5. doi: 10.1016/s0360-3016(02)03807-5.

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Hernando ML, Marks LB, Bentel GC, Zhou SM, Hollis D, Das SK, Fan M, Munley MT, Shafman TD, Anscher MS, Lind PA. Radiation-induced pulmonary toxicity: a dose-volume histogram analysis in 201 patients with lung cancer. Int J Radiat Oncol Biol Phys. 2001 Nov 1;51(3):650-9. doi: 10.1016/s0360-3016(01)01685-6.

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PMID: 11597805 (View on PubMed)

Bhatia S, Robison LL, Oberlin O, Greenberg M, Bunin G, Fossati-Bellani F, Meadows AT. Breast cancer and other second neoplasms after childhood Hodgkin's disease. N Engl J Med. 1996 Mar 21;334(12):745-51. doi: 10.1056/NEJM199603213341201.

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PMID: 8592547 (View on PubMed)

Eich HT, Haverkamp U, Engert A, Kocher M, Skripnitchenko R, Brillant C, Sehlen S, Duhmke E, Diehl V, Muller RP. Biophysical analysis of the acute toxicity of radiotherapy in Hodgkin's lymphoma--a comparison between extended field and involved field radiotherapy based on the data of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys. 2005 Nov 1;63(3):860-5. doi: 10.1016/j.ijrobp.2005.02.053. Epub 2005 May 31.

Reference Type BACKGROUND
PMID: 15925455 (View on PubMed)

Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, Coiffier B, Fisher RI, Hagenbeek A, Zucca E, Rosen ST, Stroobants S, Lister TA, Hoppe RT, Dreyling M, Tobinai K, Vose JM, Connors JM, Federico M, Diehl V; International Harmonization Project on Lymphoma. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007 Feb 10;25(5):579-86. doi: 10.1200/JCO.2006.09.2403. Epub 2007 Jan 22.

Reference Type BACKGROUND
PMID: 17242396 (View on PubMed)

IRB #70-2003: Radiation Oncology Outcome Tracking Project (RADTRAC); PI: Robert J. Amdur.

Reference Type BACKGROUND

Other Identifiers

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UFPTI 0806 - HL01

Identifier Type: -

Identifier Source: org_study_id

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