21 HL patients treated with deep inspiration breath-hold pencil-beam scanning (PBS) PT. Normal tissue radiation doses were calculated and compared to doses from 3D-conformal and partial-arc volumetric modulated (PartArc) photon RT. This study reported that treatment with PBS was well tolerated and provided with good local control.

PBS significantly reduced the mean dose to the heart, breast, lungs, spinal cord and esophagus, but some high dose measures and hot spots were increased with PBS compared to PartArc. PBS provided dosimetric advantages for patients whose clinical treatment volume extended below the 7th thoracic level and for female patients with axillary disease.