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Title: Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma

Abstract

Purpose: The use of radiotherapy in patients with advanced Hodgkin's lymphoma (HL) is controversial. The purpose of this study was to describe the role of radiotherapy in patients with advanced HL who were in partial remission (PR) after chemotherapy. Methods: In a prospective randomized trial, patients <70 years old with previously untreated Stage III-IV HL were treated with six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone/doxorubicin, bleomycine, vinblastine hybrid chemotherapy. Patients in complete remission (CR) after chemotherapy were randomized between no further treatment and involved-field radiotherapy (IF-RT). Those in PR after six cycles received IF-RT (30 Gy to originally involved nodal areas and 18-24 Gy to extranodal sites with or without a boost). Results: Of 739 enrolled patients, 57% were in CR and 33% in PR after chemotherapy. The median follow-up was 7.8 years. Patients in PR had bulky mediastinal involvement significantly more often than did those in CR after chemotherapy. The 8-year event-free survival and overall survival rate for the 227 patients in PR who received IF-RT was 76% and 84%, respectively. These rates were not significantly different from those for CR patients who received IF-RT (73% and 78%) or for those in CR who did not receivemore » IF-RT (77% and 85%). The incidence of second malignancies in patients in PR who were treated with IF-RT was similar to that in nonirradiated patients. Conclusion: Patients in PR after six cycles of mechlorethamine, vincristine, procarbazine, prednisone/doxorubicine, bleomycine, vinblastine treated with IF-RT had 8-year event-free survival and overall survival rates similar to those of patients in CR, suggesting a definite role for RT in these patients.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10];  [11];  [12];  [13];  [14]
  1. Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands). E-mail: b.aleman@nki.nl
  2. Department of Hematology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
  3. Department of Radiotherapy, Institute of Oncology, Ljubljana (Slovenia)
  4. Department of Radiotherapy, Erasmus University Medical Center, Rotterdam (Netherlands)
  5. Department of Radiotherapy, National Cancer Institute, Aviano (Italy)
  6. Department of Radiotherapy, Catharina Hospital, Eindhoven (Netherlands)
  7. Department of Radiotherapy, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)
  8. Department of Radiotherapy, Institut Gustave Roussy, Villejuif (France)
  9. Department of Radiotherapy, Oncological Center Algemeen, Ziekenhuis St. Jan, Brugge (Belgium)
  10. Department of Hematology, Erasmus University Medical Center, Rotterdam (Netherlands)
  11. Department of Radiotherapy, University Hospital, Leuven (Belgium)
  12. Department of Pathology, Netherlands Cancer Institute, Amsterdam (Netherlands)
  13. Department of Biostatistics and Epidemiology, Institut Gustave Roussy, Villejuif (France)
  14. Clinical Research Unit, Centre Francois Baclesse, Caen (France)
Publication Date:
OSTI Identifier:
20850290
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.08.041; PII: S0360-3016(06)02813-6; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; DOXORUBICIN; LYMPHOMAS; PATIENTS; PREDNISONE; RADIOTHERAPY; VINBLASTINE

Citation Formats

Aleman, Berthe M.P., Raemaekers, John M.M., Tomisic, Radka, Baaijens, Margreet H.A., Bortolus, Roberto, Lybeert, Marnix L.M., Maazen, Richard W.M. van der, Girinsky, Theodore, Demeestere, Geertrui, Lugtenburg, Pieternella, Lievens, Yolande, Jong, Daphne de, Pinna, Antonella, and Henry-Amar, Michel. Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.08.041.
Aleman, Berthe M.P., Raemaekers, John M.M., Tomisic, Radka, Baaijens, Margreet H.A., Bortolus, Roberto, Lybeert, Marnix L.M., Maazen, Richard W.M. van der, Girinsky, Theodore, Demeestere, Geertrui, Lugtenburg, Pieternella, Lievens, Yolande, Jong, Daphne de, Pinna, Antonella, & Henry-Amar, Michel. Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma. United States. doi:10.1016/j.ijrobp.2006.08.041.
Aleman, Berthe M.P., Raemaekers, John M.M., Tomisic, Radka, Baaijens, Margreet H.A., Bortolus, Roberto, Lybeert, Marnix L.M., Maazen, Richard W.M. van der, Girinsky, Theodore, Demeestere, Geertrui, Lugtenburg, Pieternella, Lievens, Yolande, Jong, Daphne de, Pinna, Antonella, and Henry-Amar, Michel. Mon . "Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma". United States. doi:10.1016/j.ijrobp.2006.08.041.
@article{osti_20850290,
title = {Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma},
author = {Aleman, Berthe M.P. and Raemaekers, John M.M. and Tomisic, Radka and Baaijens, Margreet H.A. and Bortolus, Roberto and Lybeert, Marnix L.M. and Maazen, Richard W.M. van der and Girinsky, Theodore and Demeestere, Geertrui and Lugtenburg, Pieternella and Lievens, Yolande and Jong, Daphne de and Pinna, Antonella and Henry-Amar, Michel},
abstractNote = {Purpose: The use of radiotherapy in patients with advanced Hodgkin's lymphoma (HL) is controversial. The purpose of this study was to describe the role of radiotherapy in patients with advanced HL who were in partial remission (PR) after chemotherapy. Methods: In a prospective randomized trial, patients <70 years old with previously untreated Stage III-IV HL were treated with six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone/doxorubicin, bleomycine, vinblastine hybrid chemotherapy. Patients in complete remission (CR) after chemotherapy were randomized between no further treatment and involved-field radiotherapy (IF-RT). Those in PR after six cycles received IF-RT (30 Gy to originally involved nodal areas and 18-24 Gy to extranodal sites with or without a boost). Results: Of 739 enrolled patients, 57% were in CR and 33% in PR after chemotherapy. The median follow-up was 7.8 years. Patients in PR had bulky mediastinal involvement significantly more often than did those in CR after chemotherapy. The 8-year event-free survival and overall survival rate for the 227 patients in PR who received IF-RT was 76% and 84%, respectively. These rates were not significantly different from those for CR patients who received IF-RT (73% and 78%) or for those in CR who did not receive IF-RT (77% and 85%). The incidence of second malignancies in patients in PR who were treated with IF-RT was similar to that in nonirradiated patients. Conclusion: Patients in PR after six cycles of mechlorethamine, vincristine, procarbazine, prednisone/doxorubicine, bleomycine, vinblastine treated with IF-RT had 8-year event-free survival and overall survival rates similar to those of patients in CR, suggesting a definite role for RT in these patients.},
doi = {10.1016/j.ijrobp.2006.08.041},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 67,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 2007},
month = {Mon Jan 01 00:00:00 EST 2007}
}