Chemotherapy or Combined Modality Therapy for Early-stage Hodgkin Lymphoma

Anticancer Res. 2018 May;38(5):2875-2881. doi: 10.21873/anticanres.12533.

Abstract

Background/aim: Optimizing treatment of early-stage Hodgkin lymphoma (HL) requires balancing cure with potential acute and late toxicities from treatment. We reviewed our institutional experience with chemotherapy alone (ChT) versus combined modality therapy (CMT).

Materials and methods: Patients with stage I-II classical HL in a complete response (CR) by functional imaging after chemotherapy were included. Progression-free survival (PFS) and overall survival (OS) were calculated and a multivariate analysis (MVA) was performed.

Results: A total of 136 patients with a CR to chemotherapy were identified. Consolidation radiation therapy (RT) was administered to 117 while 19 received no further therapy. PFS (5 years) was 97% with CMT and 84% with chemotherapy alone (p=0.02). Long-term (10 year) survival was no different (96 vs. 94%, p=0.8). On MVA, CMT improved PFS. Secondary malignancies were rare and no cardiac events were observed.

Conclusion: Consolidation RT results in superior PFS in early-stage Hodgkin lymphoma with minimal added toxicity.

Keywords: Radiation therapy; complete response; consolidation; metabolic imaging; positron emission tomography.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols
  • Chemoradiotherapy / methods*
  • Disease-Free Survival
  • Female
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / radiotherapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant / methods
  • Retrospective Studies
  • Young Adult