Combination chemoradiotherapy in early Hodgkin lymphoma

Hematol Oncol Clin North Am. 2014 Feb;28(1):33-47. doi: 10.1016/j.hoc.2013.10.010.

Abstract

Combination chemoradiotherapy achieves excellent results for the treatment of localized Hodgkin lymphoma. However, late toxic effects occur, mostly related to the radiotherapy administered after the standard adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. The most serious sequelae are radiation-induced secondary cancers. Reducing radiotherapy has not yet prevented late malignancies. However, when radiotherapy was omitted, tumor control was inferior, with more relapses necessitating rescue treatment including high-dose chemotherapy with stem cell support. Early fluorodeoxyglucose positron emission tomography performed after a few cycles of ABVD is evaluated in several randomized trials to identify patients who might be safely treated with chemotherapy alone.

Keywords: Chemotherapy; Fluorodeoxyglucose positron emission tomography; Radiotherapy; Second malignancies.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Fluorodeoxyglucose F18
  • Hodgkin Disease / diagnostic imaging
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / pathology
  • Hodgkin Disease / radiotherapy*
  • Humans
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Radiotherapy / adverse effects
  • Treatment Outcome

Substances

  • Fluorodeoxyglucose F18