UMMS Affiliation

Department of Radiation Oncology; Department of Quantitative Health Sciences and Cell Biology; Department of Radiation Oncology, Quality Assurance Review Center

Publication Date


Document Type



Hemic and Lymphatic Diseases | Neoplasms | Oncology | Radiology


Background and Purpose: Hodgkin lymphoma (HL) treatment has evolved to reduce or avoid radiotherapy (RT) dose and volume and minimize the potential for late effects. Some older adolescents are treated on adult protocols. The purpose of this study is to examine the protocol assignment of older adolescents and its impact on radiation dose to relevant thoracic structures.

Materials and Methods: Cooperative group data were reviewed and 12 adolescents were randomly selected from a pediatric HL protocol. Treatment plans were generated per one pediatric and two adult protocols. Dose volume histograms for heart, lung, and breast allowed comparison of radiation dose to these sites across these three protocols.

Results: A total of 15.2% of adolescents were treated on adult HL protocols and received significantly higher radiation dosage to heart and lung compared to pediatric HL protocols. Adolescents treated on either pediatric or adult protocols received similar RT dose to breast.

Conclusion: Older adolescents treated on adult HL protocols received higher RT dose to thoracic structures except breast. Level of nodal involvement may impact overall RT dose to breast. The impact of varying field design and RT dose on survival, local, and late effects needs further study for this vulnerable age group.


adolescents, young adults, Hodgkin lymphoma, radiotherapy, clinical trials

Rights and Permissions

Copyright: © 2014 Pieters, Wagner, Baker, Morano, Ulin, Cicchetti, Bishop-Jodoin and FitzGerald.

DOI of Published Version



Pieters RS, Wagner H, Baker S, Morano K, Ulin K, Cicchetti MG, Bishop-Jodoin M and FitzGerald TJ (2014) The impact of protocol assignment for older adolescents with Hodgkin lymphoma. Front. Oncol. 4:317. doi: 10.3389/fonc.2014.00317. Link to article on publisher's site

Journal/Book/Conference Title

Frontiers in Oncology

PubMed ID


Creative Commons License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.