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DOE OSTI2023

Rogers Quarry Special Studies Report 2023

Rogers Quarry (RQ) has a history of elevated Se concentrations in water and fish caused by inputs from the Y-12 National Security Complex Filled Coal Ash Pond (FCAP). Selenium is acutely toxic at high concentrations, and chronic toxicity occurs at low aqueous concentrations because Se bioaccumulates in fish tissues. The US Environmental Protection Agency (EPA) recently developed water quality criteria for Se that include fish tissue as well as aqueous Se concentrations. The water column concentration criterion is 1.5 µg L -1 for lentic ecosystems and 3.1 µg L -1 for lotic ecosystems. The fish tissue criteria include both an egg/ovary concentration (15.1 μg/g dry weight) and a concentration for whole-body (8.5 μg/g dry weight) or fish muscle (11.3 μg/g dry weight). The egg/ovary criterion supersedes the fillet and aqueous concentrations if measured because Se toxicity manifests via reproductive effects in birds and fish. It is maternally transferred through eggs, leading to teratogenicity (i.e., deformities, developmental effects) in young fish.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2025

Development of the Table of Initial Isolation and Protective Action Distances for the 2024 Emergency Response Guidebook

The transportation of hazardous materials creates numerous opportunities for the release of toxic substances into the environment, whether caused by traffic accidents, train derailments, equipment failures, or human error. Such releases can pose acute hazards to the general public and to emergency response personnel who are the first to arrive at the scene. To help first responders determine whether a shipment is potentially hazardous and decide what actions should be taken if a toxic spill does occur, the Emergency Response Guidebook (ERG) is published by the U.S. Department of Transportation (DOT), Transport Canada, and the Secretariat of Transport and Communications of Mexico; with contributions from Centro de Informaciòn Quìmica para Emergencias of Argentina. The most recent version is the 2024 edition of the ERG (ERG 2024), titled 2024 Emergency Response Guidebook (ERG2024). The ERG provides essential information about firefighting, spill response, and potential public health effects. For chemicals that are toxic by inhalation (TIH) and chemicals that produce TIH gases upon reaction with water (TIH by water reactivity or TIHWR), the ERG provides initial isolation distances (IIDs) and protective action distances (PADs). The IID defines the radius of the zone around the spill that should be accessed solely by people who are directly involved in emergency response. The PAD is the distance downwind of the source of the release within which persons should be either evacuated or sheltered in place, depending on the severity of the incident and the nature of the population (e.g., density, age, health).

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

DOE OSTI2024

Rogers Quarry Special Studies Report 2024

Rogers Quarry (RQ) has a history of elevated selenium (Se) concentrations in water and fish caused by inputs from the Y-12 National Security Complex Filled Coal Ash Pond (FCAP). Selenium is acutely toxic at high concentrations, and chronic toxicity occurs at low aqueous concentrations because Se bioaccumulates in fish tissues. The US Environmental Protection Agency (EPA) recently developed water quality criteria for Se that include fish tissue as well as aqueous Se concentrations. The water column concentration criterion is 1.5 µg L -1 for lentic ecosystems and 3.1 µg L -1 for lotic ecosystems. The fish tissue criteria include both an egg/ovary concentration (15.1 µg/g dry weight) and a concentration for whole-body (8.5 µg/g dry weight) or fish muscle (11.3 µg/g dry weight). The egg/ovary criterion supersedes the fillet and aqueous concentrations if measured because Se toxicity manifests via reproductive effects in birds and fish. It is maternally transferred through eggs, leading to teratogenicity (i.e., deformities, developmental effects) in young fish. Historical bioaccumulation data suggest that Se is likely the primary contaminant of concern in RQ, but more recent sampling shows that aqueous As concentrations have been elevated in upper McCoy Branch (MB) leading to RQ. More recently, Se concentrations in fish collected from upper MB were found to be above the tissue criterion for Se for whole-body fish. In FY 2019, actions were taken to deepen the constructed wetland just downstream of the FCAP to increase its ability to remove coal ash particulates from the water column before water enters MB. Sampling was conducted throughout MB in FY 2020-2024 to evaluate the effectiveness of the actions taken in the FCAP wetland and to measure Se concentrations in biota throughout the watershed. The methods and results from a water and fish field collection campaign in April 2024 are presented in this report.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2025

Y-12 National Security Complex Biological Monitoring and Abatement Program—2024 Calendar Year Report

This report provides the results of the CY 2024 sampling of East Fork Poplar Creek (EFPC) as part of the Y-12 National Security Complex (Y-12) Biological Monitoring and Abatement Program (BMAP). The results are presented in the context of historical trends. The Y-12 BMAP was developed in 1985 to demonstrate that the effluent limits established for Y-12 protected the classified uses of the receiving stream, particularly the growth and propagation of aquatic life (Loar et al. 1989). Over the years, the BMAP has become an important and valuable long-term measure of stream conditions resulting from actions and activities at the Y-12 Complex. The BMAP currently consists of three tasks: (1) bioaccumulation monitoring, (2) benthic macroinvertebrate community monitoring, and (3) fish community monitoring. The benthic macroinvertebrate community monitoring task includes studies to evaluate the receiving stream’s biological integrity annually in comparison with Tennessee Water Quality Criteria following Tennessee Department of Environment and Conservation (TDEC) protocols. In addition to presenting the EFPC biological monitoring results, this report includes results from Comprehensive Environmental Response, Compensation, and Liability Act–funded BMAP programs in Bear Creek and McCoy Branch (presented in Appendixes A and B, respectively), as required in the Y-12 National Pollutant Discharge Elimination System (NPDES) permit. Additional biological testing at the Y-12 Complex includes toxicity testing of select storm drains as required in the NPDES permit. Although toxicity testing is not formally part of the BMAP, toxicity testing results from 2024 are provided in Appendix C.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2021

Maturation of Rhodobacter capsulatus Multicopper Oxidase CutO Depends on the CopA Copper Efflux Pathway and Requires the cutF Product

Copper (Cu) is an essential cofactor required for redox enzymes in all domains of life. Because of its toxicity, tightly controlled mechanisms ensure Cu delivery for cuproenzyme biogenesis and simultaneously protect cells against toxic Cu. Many Gram-negative bacteria contain extracytoplasmic multicopper oxidases (MCOs), which are involved in periplasmic Cu detoxification. MCOs are unique cuproenzymes because their catalytic center contains multiple Cu atoms, which are required for the oxidation of Cu 1+ to the less toxic Cu 2+ . Hence, Cu is both substrate and essential cofactor of MCOs. Here, we investigated the maturation of Rhodobacter capsulatus MCO CutO and its role in periplasmic Cu detoxification. A survey of CutO activity of R. capsulatus mutants with known defects in Cu homeostasis and in the maturation of the cuproprotein cbb 3 -type cytochrome oxidase ( cbb 3 -Cox) was performed. This revealed that CutO activity is largely independent of the Cu-delivery pathway for cbb 3 -Cox biogenesis, except for the cupric reductase CcoG, which is required for full CutO activity. The most pronounced decrease of CutO activity was observed with strains lacking the cytoplasmic Cu chaperone CopZ, or the Cu-exporting ATPase CopA, indicating that CutO maturation is linked to the CopZ-CopA mediated Cu-detoxification pathway. Our data demonstrate that CutO is important for cellular Cu resistance under both aerobic and anaerobic growth conditions. CutO is encoded in the cutFOG operon, but only CutF, and not CutG, is essential for CutO activity. No CutO activity is detectable when cutF or its putative Cu-binding motif are mutated, suggesting that the cutF product serves as a Cu-binding component required for active CutO production. Bioinformatic analyses of CutF-like proteins support their widespread roles as putative Cu-binding proteins for several Cu-relay pathways. Our overall findings show that the cytoplasmic CopZ-CopA dependent Cu detoxification pathway contributes to providing Cu to CutO maturation, a process that strictly relies on cutF .

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2024

Protein Structure Inspired Discovery of a Novel Inducer of Anoikis in Human Melanoma

Drug discovery historically starts with an established function, either that of compounds or proteins. This can hamper discovery of novel therapeutics. As structure determines function, we hypothesized that unique 3D protein structures constitute primary data that can inform novel discovery. Using a computationally intensive physics-based analytical platform operating at supercomputing speeds, we probed a high-resolution protein X-ray crystallographic library developed by us. For each of the eight identified novel 3D structures, we analyzed binding of sixty million compounds. Top-ranking compounds were acquired and screened for efficacy against breast, prostate, colon, or lung cancer, and for toxicity on normal human bone marrow stem cells, both using eight-day colony formation assays. Effective and non-toxic compounds segregated to two pockets. One compound, Dxr2-017, exhibited selective anti-melanoma activity in the NCI-60 cell line screen. In eight-day assays, Dxr2-017 had an IC50 of 12 nM against melanoma cells, while concentrations over 2100-fold higher had minimal stem cell toxicity. Dxr2-017 induced anoikis, a unique form of programmed cell death in need of targeted therapeutics. Our findings demonstrate proof-of-concept that protein structures represent high-value primary data to support the discovery of novel acting therapeutics. This approach is widely applicable.

Oncology↗

DOE OSTI2023

Arsenic Exposure Causes Global Changes in the Metalloproteome of Escherichia coli

Arsenic is a toxic metalloid with differential biological effects, depending on speciation and concentration. Trivalent arsenic (arsenite, AsIII) is more toxic at lower concentrations than the pentavalent form (arsenate, AsV). In E. coli, the proteins encoded by the arsRBC operon are the major arsenic detoxification mechanism. Our previous transcriptional analyses indicate broad changes in metal uptake and regulation upon arsenic exposure. Currently, it is not known how arsenic exposure impacts the cellular distribution of other metals. This study examines the metalloproteome of E. coli strains with and without the arsRBC operon in response to sublethal doses of AsIII and AsV. Size exclusion chromatography coupled with inductively coupled plasma mass spectrometry (SEC-ICPMS) was used to investigate the distribution of five metals (56Fe, 24Mg, 66Zn, 75As, and 63Cu) in proteins and protein complexes under native conditions. Parallel analysis by SEC-UV-Vis spectroscopy monitored the presence of protein cofactors. Together, these data reveal global changes in the metalloproteome, proteome, protein cofactors, and soluble intracellular metal pools in response to arsenic stress in E. coli. This work brings to light one outcome of metal exposure and suggests that metal toxicity on the cellular level arises from direct and indirect effects.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2023

Short-Term Transcriptomic Points of Departure Are Consistent with Chronic Points of Departure for Three Organophosphate Pesticides across Mouse and Fathead Minnow

New approach methods (NAMs) can reduce the need for chronic animal studies. Here, we apply benchmark dose (concentration) (BMD(C))–response modeling to transcriptomic changes in the liver of mice and in fathead minnow larvae after short-term exposures (7 days and 1 day, respectively) to several dose/concentrations of three organophosphate pesticides (OPPs): fenthion, methidathion, and parathion. The mouse liver transcriptional points of departure (TPODs) for fenthion, methidathion, and parathion were 0.009, 0.093, and 0.046 mg/Kg-bw/day, while the fathead minnow larva TPODs were 0.007, 0.115, and 0.046 mg/L, respectively. The TPODs were consistent across both species and reflected the relative potencies from traditional chronic toxicity studies with fenthion identified as the most potent. Moreover, the mouse liver TPODs were more sensitive than or within a 10-fold difference from the chronic apical points of departure (APODs) for mammals, while the fathead minnow larva TPODs were within an 18-fold difference from the chronic APODs for fish species. Short-term exposure to OPPs significantly impacted acetylcholinesterase mRNA abundance (FDR p-value <0.05, |fold change| ≥2) and canonical pathways (IPA, p-value <0.05) associated with organism death and neurological/immune dysfunctions, indicating the conservation of key events related to OPP toxicity. Together, these results build confidence in using short-term, molecular-based assays for the characterization of chemical toxicity and risk, thereby reducing reliance on chronic animal studies.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2024

Machine Learning Framework for Conotoxin Class and Molecular Target Prediction

Conotoxins are small and highly potent neurotoxic peptides derived from the venom of marine cone snails which have captured the interest of the scientific community due to their pharmacological potential. These toxins display significant sequence and structure diversity, which results in a wide range of specificities for several different ion channels and receptors. Despite the recognized importance of these compounds, our ability to determine their binding targets and toxicities remains a significant challenge. Predicting the target receptors of conotoxins, based solely on their amino acid sequence, remains a challenge due to the intricate relationships between structure, function, target specificity, and the significant conformational heterogeneity observed in conotoxins with the same primary sequence. We have previously demonstrated that the inclusion of post-translational modifications, collisional cross sections values, and other structural features, when added to the standard primary sequence features, improves the prediction accuracy of conotoxins against non-toxic and other toxic peptides across varied datasets and several different commonly used machine learning classifiers. Here, we present the effects of these features on conotoxin class and molecular target predictions, in particular, predicting conotoxins that bind to nicotinic acetylcholine receptors (nAChRs). We also demonstrate the use of the Synthetic Minority Oversampling Technique (SMOTE)-Tomek in balancing the datasets while simultaneously making the different classes more distinct by reducing the number of ambiguous samples which nearly overlap between the classes. In predicting the alpha, mu, and omega conotoxin classes, the SMOTE-Tomek PCA PLR model, using the combination of the SS and P feature sets establishes the best performance with an overall accuracy (OA) of 95.95%, with an average accuracy (AA) of 93.04%, and an f1 score of 0.959. Using this model, we obtained sensitivities of 98.98%, 89.66%, and 90.48% when predicting alpha, mu, and omega conotoxin classes, respectively. Similarly, in predicting conotoxins that bind to nAChRs, the SMOTE-Tomek PCA SVM model, which used the collisional cross sections (CCSs) and the P feature sets, demonstrated the highest performance with 91.3% OA, 91.32% AA, and an f1 score of 0.9131. The sensitivity when predicting conotoxins that bind to nAChRs is 91.46% with a 91.18% sensitivity when predicting conotoxins that do not bind to nAChRs.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2026

Biobased Flame Retardants Towards Sustainable Building Materials with Low Embodied Carbon

Incorporation of fire retardants in different types of products is one of the essential steps in the material production process to minimize fire risk and meet fire safety requirements. A variety of commonly used flame retardants based on halogen, mineral, and other compounds has gained popularity due to their efficient flame-retardant behaviors. However, especially in the case of halides, there are numerous toxicity related issues and environmental pollution effects that have urged the building sector to deviate from their use and focus on the development of non-toxic alternatives. Therefore, to enhance the safety of flame retardants, the synthesis of flame retardants from waste feedstocks using phosphorous chemistry with a dual flame-retardant mechanism has been established. A range of waste feedstocks that include cardanol, vanillin, and gallic acids has been converted into a series of flame retardants using a one-step approach by incorporating phosphorous moieties into their structures. The established pathways allow to develop a range of flame-retardant materials by converting waste feedstocks into phosphorous-based materials with inherent flame retardancy. The introduction of abundant aromatic structures from biobased feedstocks enables high charring capabilities in materials in which these biobased flame retardants have been incorporated, increasing their char yields which significantly enhances the flame suppressing properties of the designed materials. Studies show that inclusion of phosphoric moieties into structures allows the displacement of flame enhancing radicals, by releasing non-flammable and non-toxic gases, therefore inhibiting the spread of fire in the gas phase. The resulting biobased flame retardants have been incorporated in wood substrates, foam insulation, and hemp fibers where the results show that only 1-5% of loading of biobased flame retardant suppressed the flame completely. This study represents a novel approach for the development of flame retardants with high performance while utilizing waste feedstocks as a source for their design.

Demchuk, Zoriana [ORNL] (ORCID:0000000326292235)↗

DOE OSTI2020

Therapeutic genetic variation revealed in diverse Hsp104 homologs

The AAA+ protein disaggregase, Hsp104, increases fitness under stress by reversing stress-induced protein aggregation. Natural Hsp104 variants might exist with enhanced, selective activity against neurodegenerative disease substrates. However, natural Hsp104 variation remains largely unexplored. Here, we screened a cross-kingdom collection of Hsp104 homologs in yeast proteotoxicity models. Prokaryotic ClpG reduced TDP-43, FUS, and α-synuclein toxicity, whereas prokaryotic ClpB and hyperactive variants were ineffective. Furthermore, we uncovered therapeutic genetic variation among eukaryotic Hsp104 homologs that specifically antagonized TDP-43 condensation and toxicity in yeast and TDP-43 aggregation in human cells. We also uncovered distinct eukaryotic Hsp104 homologs that selectively antagonized α-synuclein condensation and toxicity in yeast and dopaminergic neurodegeneration in C. elegans . Surprisingly, this therapeutic variation did not manifest as enhanced disaggregase activity, but rather as increased passive inhibition of aggregation of specific substrates. By exploring natural tuning of this passive Hsp104 activity, we elucidated enhanced, substrate-specific agents that counter proteotoxicity underlying neurodegeneration.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2020

Green chemistry design in polymers derived from lignin: review and perspective

The use of lignin for material and chemical applications has gained interest in recent times due to the environmental focus on using biomass for renewable materials as well as the motivation to valorize lignin as part of an integrated biorefinery. While a wealth of publications can be found for lignin-derived materials, and several reviews can be found on the topic, there are no reviews that outline and critically assess the sustainability of these protocols based on the criterion of the 12 Principles of Green Chemistry. This review assesses the literature for lignin- derived polymers over the past 20 years and highlights attempts to use biobased accompanying reagents, green solvents or solvent-less protocols, reports that replace traditionally toxic precursors (e.g. diisocyanates for polyurethanes), use mild conditions, valorize additional waste streams and prepare materials particularly biodegradable or recyclable. Here, the following work is a comprehensive and critical assessment of the green and sustainable nature of the state-of-the art of lignin-derived polymers (polyurethane, polyester, epoxy, phenolic resin, and others) utilizing actual biomass in the synthetic protocol. Each section of this review highlights and assesses published protocols that use a particularly green approach in one or more steps of the synthetic sequence. While many reports still contain traditional petroleum-derived and toxic methods along with more sustainable methods, the outline of all such green methods is able to create a landscape amidst lignin-derived polymer synthesis that points the way toward safer and more environmentally friendly materials.

36 MATERIALS SCIENCE↗

DOE OSTI2021

Metal leaching from Lithium-ion and Nickel-metal hydride batteries and photovoltaic modules in simulated landfill leachates and municipal solid waste materials

Photovoltaic (PV) modules and batteries can either be recycled or disposed of in landfills at end-of-life (EoL). This work focuses on disposal since the benefit of recycling PV modules and batteries is well established. This study characterizes the potential toxicity due to metals leaching from selected PV modules and batteries through both the Toxicity Characteristic Leaching Procedure (TCLP) and in-house batch leaching protocols to probe the impact on metallic ion mobility as a function of the different types of e-waste entering the waste stream, the magnitude of device damage when placed into the waste stream, and the simulated municipal solid waste (SMSW) composition. Our results showed that one PV module and three battery types in this study should be classified as hazardous waste within the U.S. However, for some of the other e-wastes, metals of concern including Cr, Cu, Hg, Ni, Pb, and Zn leached during the batch tests but not in the TCLP regulatory method. For most of the waste types, the amounts of metals that leached in the TCLP test and batch tests were much lower than the total extractable amounts, demonstrating the potential for additional unaccounted for amounts of metals to leach. Our results demonstrate that the TCLP regulatory method might fail at predicting potential leaching and at capturing the complexity of e-waste leaching in landfill conditions. It confirms that additional work is needed urgently to develop appropriate EoL procedures for MSW with PV and battery e-waste.

42 ENGINEERING↗

DOE OSTI2021

Copper transformation, speciation, and detoxification in anoxic and suboxic freshwater sediments

The complex chemistry of copper (Cu) in freshwater sediments at low concentrations is not well understood. We evaluated the transformation processes of Cu added to freshwater sediments under suboxic and anoxic conditions. Freshwater sediments from three sources in Michigan with different characteristics (Spring Creek, River Raisin, and Maple Lake) were spiked with 30 or 60 mg kg -1 Cu and incubated under a nitrogen atmosphere. After 28-d, each treatment subset was amended with organic matter (OM) to promote anoxic conditions and evaluate its effects on Cu speciation. OM addition triggered a shift from suboxic to anoxic conditions, and sequential extractions showed that Cu accordingly shifted from acid-soluble to oxidizable fractions. Extended X-ray absorption fine-structure (EXAFS) spectroscopy revealed that Cu sulfides dominated all anoxic samples except for Spring Creek 30 mg kg -1 , where Cu(I) was predominantly complexed to thiol groups of OM. Covellite and chalcopyrite (CuFeS 2 ) were the predominant Cu species in nearly all anoxic samples, as determined by Raman spectroscopy, scanning electron microscopy, and X-ray absorption near-edge structure (XANES) spectroscopy. Copper reduction also occurred under suboxic conditions: for two of three sediments, around 80% had been reduced to Cu(I), while the remaining 20% persisted as Cu(II) complexed to OM. However, in the third coarsest (i.e., Spring Creek), around 50% of the Cu had been reduced, forming Cu(I)-OM complexes, while the remainder was Cu(II)-OM complexes. Toxicity tests showed that survival of H. azteca and D. magna were significantly lower in suboxic treatments. Anoxic sediments triggered a near-complete transformation of Cu to sulfide minerals, reducing its toxicity.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

DOE OSTI2024

Overcoming barriers to medium-chain fatty alcohol production

Medium-chain fatty alcohols ( mc FaOHs) are aliphatic primary alcohols containing six to twelve carbons that are widely used in materials, pharmaceuticals, and cosmetics. Microbial biosynthesis has been touted as a route to less-abundant chain-length molecules and as a sustainable alternative to current petrochemical processes. Several metabolic engineering strategies for producing mc FaOHs have been demonstrated in the literature, yet processes continue to suffer from poor selectivity and mc FaOH toxicity, leading to reduced titers, rates, and yields of the desired compounds. Here, this opinion examines the current state of microbial mc FaOH biosynthesis, summarizing engineering efforts to tailor selectivity and improve product tolerance by implementing engineering strategies that circumvent or overcome mc FaOH toxicity.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2021

In vitro effects of cannabidiol and its main metabolites in mouse and human Sertoli cells

Cannabidiol (CBD) is a major cannabinoid present in extracts of the plant Cannabis sativa (marijuana). While the therapeutic effects of CBD on epilepsy have been demonstrated, less is understood regarding its potential adverse effects. Recent studies revealed that CBD induced toxicity in the male reproductive system of animal models. In this study, we used TM4, an immortalized mouse Sertoli cell line, and primary human Sertoli cells to evaluate the toxicities of CBD and its main metabolites, 7-carboxy-CBD and 7-hydroxy-CBD. CBD induced concentration- and time-dependent cytotoxicity in mouse and human Sertoli cells, which mainly resulted from the inhibition of the G1/S-phase cell cycle transition. CBD also inhibited DNA synthesis and downregulated key cell cycle proteins. Moreover, CBD reduced the mRNA and protein levels of a functional marker, Wilms’ tumor 1. Similar to CBD, 7-carboxy-CBD and 7-hydroxy-CBD inhibited cellular proliferation and decreased DNA synthesis. 7-Carboxy-CBD was less cytotoxic than CBD, while 7-hydroxy-CBD showed comparable cytotoxicity to CBD in both mouse and human Sertoli cells. Compared to mouse Sertoli cells, CBD, 7-hydroxy-CBD, and 7-carboxy-CBD were more cytotoxic in human Sertoli cells. Finally, our results indicate that CBD and its main metabolites can inhibit cell proliferation in mouse and human Sertoli cells.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2021

Individualized Adaptive Radiation Therapy Allows for Safe Treatment of Hepatocellular Carcinoma in Patients With Child-Turcotte-Pugh B Liver Disease

Previous reports of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) suggest unacceptably high rates of toxicity in patients with Child-Turcotte-Pugh (CTP) B liver disease. We hypothesized that an individualized adaptive treatment approach based on midtreatment liver function would maintain good local control while limiting toxicity in this population.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2021

Risk of Pneumonitis and Outcomes After Mediastinal Proton Therapy for Relapsed/Refractory Lymphoma: A PTCOG and PCG Collaboration

Despite high response rates, there has been reluctance to use radiation therapy for patients with relapsed/refractory (r/r) Hodgkin (HL) or aggressive non-Hodgkin lymphoma (NHL) given concerns for subacute and late toxicities. Symptomatic pneumonitis, a subacute toxicity, has an incidence of 17% to 24% (≥grade 2) even with intensity modulated radiation therapy. Proton therapy (PT), which has no exit radiation dose, is associated with a lower dose to lung compared with other radiation techniques. As risk of radiation pneumonitis is associated with lung dose, we evaluated whether pneumonitis rates are lower with PT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗