Lymphomas mostly affect young patients, with 15 to 20 new cases per 100,000 inhabitants annually worldwide.

Lymphomas are divided into two general types, Hodgkin’s lymphomas (HL) and non-Hodgkin’s lymphomas (NHL).

These diseases are most commonly treated with chemotherapy or a combination of chemotherapy and biological therapy. In some cases, irradiation treatment is also added. International treatment protocols recommend that proton therapy should always be considered as the first choice due to its ability to protect healthy organs.

The prognosis of lymphoma is often very good, with long-term survival rate of 60% (NHL) to 80% (HL). That is why we should always consider proton therapy, the most sensitive treatment that minimizes the complications associated with late and very late toxicity.

Thanks to proton therapy, we can prevent secondary tumors from radiation and increase the anti-tumor efficacy of the treatment.

Lymphoma is a general term for cancer of the lymphatic system. Lymphomas refer to tumors that come from one type of white blood cells, known as lymphocytes. The cells of the lymphatic system are uncontrollably dividing, and the affected nodes (or groups of nodes) begin to grow, cease to serve for the body as a whole, and lose their original function. Since the lymphatic tissue is present throughout the body, the disease can also affect other organs outside the lymph nodes.

To make the right decision, it is important to have information about the results of the treatment you choose. You should not forget that your decision will significantly affect your future life. Our doctors and the entire PTC team are ready to answer all your questions related to PROTON THERAPY.

Do not hesitate to contact us as soon as possible .

By simply comparing the risks and benefits generally associated with radiation therapy, you come to the conclusion that proton therapy increases the patient’s chances of cure without unnecessary risks and complications associated with conventional irradiation.

Do not hesitate to contact us as soon as possible.

The priority is to protect healthy organs.

Since lymphomas are located in certain parts of the body where they are surrounded by vital organs such as the heart, spinal cord, lungs and esophagus, it is all the more necessary to use a method of treatment that can destroy the tumor lesion, while protecting the healthy organs and tissues as much as possible. These requirements are best met by proton therapy.

Conventional photon irradiation cannot reduce the risks to the same extent as proton therapy.

Proton therapy is a highly effective method of treating cancer by irradiation, primarily due to the physical properties of protons and their precisely targeted and metered dose within the tissues. This method can be used to achieve greater antitumor efficacy, less damage to healthy tissues, low risk of complications, a chance to recover more quickly after treatment, and a higher overall quality of life.

If conventional irradiation was selected, a large percentage of patients could experience late and very late toxicity. In other words, the effects of unwanted radiation to the healthy tissues and organs, including their damage, or secondary tumors from radiation may occur or develop in many patients long after the end of treatment. Therefore, it is necessary to choose a treatment that minimizes these risks. These requirements are best met by proton therapy.

The key to successful treatment is early diagnosis.

In the treatment of Hodgkin’s and non-Hodgkin’s lymphoma, proton therapy can reduce the dose to the lungs by 50%. At the same time, it can reduce the dose to the heart valves.

It can even reduce the dose to the spinal cord to the minimum, which greatly reduces the risk of post-radiation myelopathy (motor damage).

Due to the high precision of the proton beam, you have a higher chance of cure. Protons can precisely target the tumor and accurately distribute the dose of radiation needed for tumor destruction. The exact dose distribution has its name: Pencil Beam Scanning (PBS) and is currently the absolute peak of proton therapy. Pencil Beam Scanning (PBS) works such that it only irradiates a defined area. Not more. By delivering repeated high-precision radiation targeted with millimeter accuracy directly to the tumor bed after resection, PBS destroys the tumor cells without damaging any surrounding organs and tissues due to the physical properties of the protons. PBS preserves healthy tissues. This also applies to the tissues in the direction of the beam in front of the tumor, which are only minimally irradiated.

To compare PBS with other techniques, imagine your focus and meticulous care when you are using crayons to paint a defined object on a piece of paper. For example, a circle. You will always try consistently not to cross its borders. That is how PBS works. In addition, you will have 100% confidence that they will “paint” only what is needed. This is why the adverse effects of proton therapy are minimal.

Proton therapy reduces complications to a minimum

Lymph node tumors are a disease that affects young patients in particular. During their treatment, it is very important to choose methods that will limit the occurrence of late side effects. Proton therapy is the treatment of choice for patients with lymphomas, even in prestigious international recommendations.

The proton beam can be stopped safely with millimeter accuracy and exactly at the place where we need it – in this case the tumor. Healthy tissues in front of the tumor are only minimally affected by radiation, while tissues in the vicinity of and behind the tumor are not irradiated at all.

Proton therapy for lymphatic tissue tumors makes it possible:

• to deliver a sufficient dose to the entire target area, while better protecting the surrounding healthy tissue;
• in the chest area, to reduce the undesirable dose of radiation to the mammary gland, lungs, heart and spinal cord;
• in the abdomen and pelvis, to reduce the undesirable dose of radiation to the intestines, kidneys, liver, ovaries and uterus, urinary bladder and rectum;
• in the head and neck area, to reduce the undesirable dose of radiation to the eye structures, spinal cord, brainstem and oral cavity;
• to reduce the risk of late complications associated with conventional radiation (development of cardiovascular diseases, development of secondary malignancies and others).

BENEFITS OF PROTON radioTHERAPY:

• reduced doses to the heart muscle, with reduced risk of inducing late effects of radiotherapy, such as valvular defects, ischemic heart disease, and/or arrhythmia;
• reduced doses to the pulmonary parenchyma, with reduced risk of developing pulmonary fibrosis;
• reduced doses to the spinal cord, with reduced risk of post-radiation myelopathy (motor damage);
• reduced doses to the mammary gland, with reduced risk of inducing secondary malignancies;
• the above-mentioned dose reduction is clinically significant and typically involves a dose reduction by 50% or more.

DID YOU KNOW THAT…

Proton radiotherapy leads to a significant reduction in doses to the healthy tissues and is therefore considered a “best clinical practice” by the National Cancer Comprehensive Network (NCCN) international guidelines.

Proton beam therapy is a safer and more effective treatment compared to conventional radiation therapy. The goal of radiation therapy is to destroy the tumor while protecting the healthy tissues. This can be done by proton therapy, unlike commonly used conventional irradiation. Conventional radiotherapy always hits a part of the healthy tissue in the surrounding areas, where irradiation is not desirable.

Proton beams can irradiate the tumor while delivering no dose to the corresponding critical organ. A zero dose means a zero risk of adverse reactions. No patient will ever experience such adverse effects. Due to their physical properties, proton beams are able to stop in the tumor, thus significantly reducing the unwanted exposure of healthy tissues and organs.

Some advocates of conventional (photon) radiotherapy sometimes use a “magic formula” of “limit doses” to the critical organs. What does this mean? A patient is told that a limit dose to the critical organs will be observed. This is actually an “agreement” that we are accepting exposure of vital organs to unwanted radiation, but with a certain limit. But the patient is further told that adherence to the “limit dose” is associated with up to a 5% risk of adverse reactions. In addition, the risk increases with time, which means the longer a patient survives after irradiation, the higher the probability of adverse reactions.

Think carefully. The limit dose may not always be safe. And more importantly, safer and easily accessible proton therapy is available to rule out the risk.

The difference is seen with the naked eye in the graphical representation of irradiation plans.

The objective of the treatment is to deliver the required dose of radiation to the tumor (100%). Equally important, however, is not to irradiate the surrounding healthy tissues and organs. These requirements are met by proton therapy, which protects the the heart, lungs, breasts, and spinal cord, and other important organs. Conventional irradiation, however, would affect them, and the patient is at risk of unpleasant complications.

Proton therapy is an increasingly recognized and preferred method in the world. The advantages are obvious and therefore new and new centers are opened and planned. At present, 71 centers are opened, 42 centers are just before the opening, and dozens more are planned. In visionary terms, we could predict with a relatively high degree of probability that proton beam irradiation will replace now frequently used conventional radiation therapy in the future.

The results and experience of the world’s proton centers also unambiguously confirm that proton therapy opens up entirely new possibilities in the treatment of head and neck tumors and offers patients a chance for a complete cure. Proton therapy can deliver the highest dose of radiation to the tumor, safely and without risks for the surrounding tissues. The added value of proton therapy compared to conventional (photon) therapy is that it spares healthy tissues around the tumor.      Do not hesitate to contact us as soon as possible.

Did you know that…?

The rationale for the suitability of proton therapy indications in malignant lymphomas is also justified in the 2016 NCCN Guidelines (National Comprehensive Cancer Network, an alliance of leading cancer centers specialized in patient care, research and education). Proton therapy is now classified among the advanced radiotherapy techniques for treatment of lymphomas that can offer a clinically significant and substantial benefit in sparing important high-risk organs. Moreover, these protocols deny the need for randomized clinical trials before using proton RT (as a technique with the potential to reduce late and very late toxicity) in clinical practice. This technique, which is associated with a clinically significant minimization of exposure to the high-risk organs, provided that the target volume is preserved, should be considered regardless of the absence of randomized clinical trials.

In addition, proton RT is recommended in the section “Diagnostic and therapeutic procedures in patients with malignant lymphomas” by the Czech Cooperative Lymphoma Group in 2013.