You need JavaScript to view this

Radiotherapy salvage for Hodgkin's disease after chemotherapy failure

Abstract

Purpose/Objective: The precise role of salvage radiotherapy (RT) following chemotherapy (CT) failure in patients with Hodgkin's disease (HD) remains undefined. The aims of this study are: (1) to assess the pattern of failure, failure-free and overall survival, in patients who receive salvage RT for HD after CT failure; and (2) to identify patient subsets most suitable for this treatment approach. Materials and Methods: A review of patients treated between 1978 and 1992 at the Peter MacCallum Cancer Institute identified 52 patients with relapsed/refractory HD following CT who received RT with curative intent. Eligibility for this study required either biopsy confirmation of relapse/residual disease, or else clear clinical or radiological disease progression. Patient characteristics at diagnosis: median age 26, with 32% > 40 years old; M/ F 31/21; stage I-4, II-16, III-25, IV-7. Initial CT was MOPP- 31 patients, ABVD-1, both-16. A median 6 cycles of CT was given per regimen. Prior to salvage RT, 26/52 patients had received both MOPP and ABVD, either as sequential regimens, or as alternating or hybrid protocols. The response to initial CT was: CR-30, PR/SD-18, PD-4. Duration of initial CR was < 12 months in 8/30 patients. Salvage treatment consisted of radiotherapy to all known  More>>
Publication Date:
Jul 01, 1995
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 32; Journal Issue: 971; Other Information: Copyright (c) 1995 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); PBD: 1995
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTINEOPLASTIC DRUGS; CHEMOTHERAPY; HODGKINS DISEASE; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SELECTION RULES; SURVIVAL CURVES
OSTI ID:
20420665
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US03R1901005070
Submitting Site:
INIS
Size:
page(s) 214
Announcement Date:
Feb 11, 2004

Citation Formats

Wirth, A, Corry, J, and Liew, K H. Radiotherapy salvage for Hodgkin's disease after chemotherapy failure. United States: N. p., 1995. Web. doi:10.1016/0360-3016(95)97809-F.
Wirth, A, Corry, J, & Liew, K H. Radiotherapy salvage for Hodgkin's disease after chemotherapy failure. United States. doi:10.1016/0360-3016(95)97809-F.
Wirth, A, Corry, J, and Liew, K H. 1995. "Radiotherapy salvage for Hodgkin's disease after chemotherapy failure." United States. doi:10.1016/0360-3016(95)97809-F. https://www.osti.gov/servlets/purl/10.1016/0360-3016(95)97809-F.
@misc{etde_20420665,
title = {Radiotherapy salvage for Hodgkin's disease after chemotherapy failure}
author = {Wirth, A, Corry, J, and Liew, K H}
abstractNote = {Purpose/Objective: The precise role of salvage radiotherapy (RT) following chemotherapy (CT) failure in patients with Hodgkin's disease (HD) remains undefined. The aims of this study are: (1) to assess the pattern of failure, failure-free and overall survival, in patients who receive salvage RT for HD after CT failure; and (2) to identify patient subsets most suitable for this treatment approach. Materials and Methods: A review of patients treated between 1978 and 1992 at the Peter MacCallum Cancer Institute identified 52 patients with relapsed/refractory HD following CT who received RT with curative intent. Eligibility for this study required either biopsy confirmation of relapse/residual disease, or else clear clinical or radiological disease progression. Patient characteristics at diagnosis: median age 26, with 32% > 40 years old; M/ F 31/21; stage I-4, II-16, III-25, IV-7. Initial CT was MOPP- 31 patients, ABVD-1, both-16. A median 6 cycles of CT was given per regimen. Prior to salvage RT, 26/52 patients had received both MOPP and ABVD, either as sequential regimens, or as alternating or hybrid protocols. The response to initial CT was: CR-30, PR/SD-18, PD-4. Duration of initial CR was < 12 months in 8/30 patients. Salvage treatment consisted of radiotherapy to all known areas of disease. Doses ranged from 3600-4000 cGy. Results: Twenty three patients (45%) achieved CR. With a median follow-up of 70 months (range 4.8-166), actuarial median failure free survival (FFS) and overall survival (OS) are 22 months and 83 months respectively. Actuarial 5 year FFS and OS are 26% and 57% respectively. Patients with CR duration > 12 months following initial CT, only one CT regimen prior to salvage RT, and anatomically limited relapse had a significantly longer FFS. These factors, and age < 40 were associated with significantly longer OS. Only 6% of patients failed solely in the irradiated volume as first site of relapse, with the total in-field relapse of 30%. Sixty-four percent of these were at prior sites of disease. Fifty-three percent failed outside the treated volume, 73% of these at sites not previously involved. Salvage RT was well tolerated and resulted in no treatment-related deaths. Conclusion: These results are in keeping with previous reports of RT salvage in HD. RT is of benefit in selected patients with HD who fail CT-in in particular, patients with a long initial disease-free-interval and anatomically limited relapse. It is difficult to compare these results with conventional and high dose CT studies because of variations in selection criteria and reporting. The optimal integration of RT in salvage strategies for Hodgkin's disease requires further study.}
doi = {10.1016/0360-3016(95)97809-F}
journal = {International Journal of Radiation Oncology, Biology and Physics}
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}