Details

Autor(en) / Beteiligte

• Gunther, Jillian R., MD, PhD
• Fanale, Michelle A., MD
• Reddy, Jay P., MD, PhD
• Akhtari, Mani, MD
• Smith, Grace L., MD, PhD
• Pinnix, Chelsea C., MD, PhD
• Milgrom, Sarah A., MD
• Yehia, Zeinab Abou, MD
• Allen, Pamela K., PhD
• Osborne, Eleanor M., MD
• Mawlawi, Osama, PhD
• Dabaja, Bouthaina S., MD

Titel

Treatment of Early-Stage Unfavorable Hodgkin Lymphoma: Efficacy and Toxicity of 4 Versus 6 Cycles of ABVD Chemotherapy With Radiation

Ist Teil von

• International journal of radiation oncology, biology, physics, 2016-09, Vol.96 (1), p.110-118

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose The German Hodgkin Study Group HD11 trial validated 4 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy followed by involved field radiation therapy (IFRT) for early unfavorable Hodgkin lymphoma (HL) patients. However, practitioners often recommend 6 cycles followed by RT, especially for bulky disease. We compared patient outcomes after treatment with 4 or 6 cycles of ABVD followed by RT (IFRT and involved site RT [ISRT]). Methods and Materials We identified 128 patients treated for early unfavorable HL (GHSG criteria) between 2000 and 2013. Clinical outcomes (overall survival [OS] and freedom from relapse [FFR]) were estimated using Kaplan-Meier analysis. Toxicities were evaluated. Results The median follow-up time was 5.0 years. Patients received 4 (70 patients, 55%) or 6 (58 patients, 45%) cycles of chemotherapy. Bulky disease was present in 22 patients (31%; 0 stage IA, 3 stage IB, 19 stage IIA) of the 4-cycle group and 42 patients (72%; 5 stage IA, 3 stage IB, 34 stage IIA) of the 6-cycle group. For patients receiving 4 and 6 cycles, the 6-year OS was 100% and 97% ( P =.35), respectively, and the 6 year FFR was 100% and 98% ( P =.28), respectively. More patients received 6 cycles if they were treated before 2010 (HD11 report) ( P =.01) and if they had bulky disease ( P <.01). Sixty-eight percent of patients received ISRT. The 6-year FFR was 99% and 100% for patients receiving ISRT and IFRT, respectively ( P =.58). More patients experienced bleomycin pulmonary toxicity in the 6-cycle group (20% vs 31%, P =.16). For patients with bulky disease, the 4-year FFR was similar with receipt of 4 (100%) or 6 (98%) cycles ( P =.48) and IFRT (100%) or ISRT (98%) ( P =.52). There were no deaths among patients with bulky disease. Conclusions Patients with early unfavorable HL have excellent outcomes with 4 cycles of ABVD chemotherapy followed by ISRT. Six cycles of chemotherapy does not appear superior for disease control, even for bulky disease.