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Fifteen-Year Experience of a Single Institution: Outcomes for Early-Stage Hodgkins Lymphoma Comparing Chemotherapy Alone Versus Combined Modality Therapy.

Author information

Affiliations

  • 1. Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia.
      Authors
    • Qian JY 1
    (1 author)
  • 2. Department of Medicine, The Medical College of Georgia School of Medicine, Augusta, Georgia.
      Authors
    • Amin R 2
    • Ali H 2
    (2 authors)
  • 3. Department of Biostatistics and Bioinformatics, Biostatistics Shared Resource, Winship Cancer Institute, Atlanta, Georgia.
      Authors
    • Cao Y 3
    (1 author)
  • 4. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, Georgia.
      Authors
    • Switchenko JM 4
    (1 author)
  • 5. Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
      Authors
    • Rashid AS 5
    • Hanasoge S 5
    • Khan MK 5
    (3 authors)
    • Show all (6)

Advances in Radiation Oncology, 24 Sep 2024, 9(12):101636
https://doi.org/10.1016/j.adro.2024.101636 PMID: 39524528 

Abstract 

Purpose

Doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy is the current standard treatment for early-stage Hodgkins lymphoma (HL). The use of consolidative radiation therapy (RT) in addition to chemotherapy may lead to better survival rates but is controversial because of concerns about long-term toxicity. The aim of this study is to compare outcomes of patients receiving ABVD chemotherapy alone (CTX alone) versus ABVD with consolidative RT (CMT).

Methods and materials

A single-institution, retrospective review of patients with HL diagnosed from 2000 to 2014 was conducted. Patients were identified from the National Cancer Database. Inclusion criteria included patients aged ≥18 years, with stage I or II HL, who received ABVD with a complete response with/without CMT. Consolidative RT must have been started within 90 days of completing chemotherapy. Institutional review board approval was obtained. Follow-up details and treatment responses were collected from medical record reviews. Standard statistical analysis and Kaplan-Meier curves were used to estimate relapse-free survival (RFS).

Results

One hundred and 8 patients with early-stage HL were identified. The median age at diagnosis was 31 years (range, 19-72). Most patients were female (63%) and Caucasian (65%). stage II HL was present in 89%of patients, 89% had an Eastern Cooperative Oncology Group score of 0 or 1, 35% had B symptoms, and 9% had extranodal involvement. A total of 52.8% received CMT (n = 57) and 47.2% received CTX alone (n = 51). The CMT group had fewer cycles of chemotherapy compared to the CTX-alone group (mean cycles, 5.2 vs 5.7, P = 0.045). Twenty-four relapse events occurred in the CTX-alone group, while no relapse events occurred in the CMT group. RFS at 10 years was significantly improved in the CMT group (100%) compared to CTX alone (47.4%, P < .0001; HR = .03, P < .001).

Conclusions

ABVD with consolidative RT was associated with improved RFS. Further studies of toxicity comparisons, advanced stages, and nonfavorable HL are warranted.

Full text links 

Read article at publisher's site: https://doi.org/10.1016/j.adro.2024.101636

References 

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