The role of radiation therapy in patients with Hodgkin's lymphoma

Current Hematologic Malignancy Reports

Volumn 2, Issue 3, 2007, Pages 151-160

  Aleman, Berthe M P ^b   Re, Daniel ^b   Diehl, Volker ^a  

^a UNIVERSITY HOSPITAL OF COLOGNE   (Germany)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANTHRACYCLINE; BLEOMYCIN; CHLORMETHINE; CYCLOPHOSPHAMIDE; DACARBAZINE; DOXORUBICIN; EPIRUBICIN; ETOPOSIDE; PREDNISONE; PROCARBAZINE; VINBLASTINE; VINCRISTINE;

CANCER RADIOTHERAPY; CANCER SCREENING; CANCER STAGING; CARDIOTOXICITY; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; HODGKIN DISEASE; HUMAN; INTERMETHOD COMPARISON; META ANALYSIS; MULTIPLE CYCLE TREATMENT; PROGNOSIS; RADIATION DOSE; REVIEW; SYSTEMATIC REVIEW;

ADULT; ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; CLINICAL TRIALS AS TOPIC; COMBINED MODALITY THERAPY; DISEASE-FREE SURVIVAL; FEMALE; FOLLOW-UP STUDIES; HODGKIN DISEASE; HUMANS; MALE; META-ANALYSIS AS TOPIC; MULTICENTER STUDIES AS TOPIC; RADIOTHERAPY; RADIOTHERAPY DOSAGE; REMISSION INDUCTION; RISK FACTORS; SURVIVAL RATE; TREATMENT OUTCOME; YOUNG ADULT;

EID: 34547730905     PISSN: 15588211     EISSN: 1558822X     Source Type: Journal    
DOI: 10.1007/s11899-007-0021-3     Document Type: Review

References (51)

1. Kaplan HS: Hodgkin's disease: biology, treatment, prognosis. Blood 1981, 57:813-822.
2. Bonadonna G, Valagussa P, Santoro A: Alternating non-cross-resistant combination chemotherapy or MOPP in stage IV Hodgkin's disease. A report of 8-year results. Ann Intern Med 1986, 104:739-746.
3. Aleman BM, van den Belt-Dusebout AW, Klokman WJ, et al.: Long-term cause-specific mortality of patients treated for Hodgkin's disease. J Clin Oncol 2003, 21:3431-3439.
4. Hancock SL, Hoppe RT: Long-term complications of treatment and causes of mortality after Hodgkin's disease. Semin Radiat Oncol 1996, 6:225-242.
5. Swerdlow AJ, Barber JA, Hudson GV, et al.: Risk of second malignancy after Hodgkin's disease in a collaborative British cohort: the relation to age at treatment. J Clin Oncol 2000, 18:498-509.
6. van Leeuwen FE, Klokman WJ, Veer MB, et al.: Long-term risk of second malignancy in survivors of Hodgkin's disease treated during adolescence or young adulthood. J Clin Oncol 2000, 18:487-497.
7. • Swerdlow AJ, Higgins CD, Smith P, et al.: Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study. J Natl Cancer Inst 2007, 99:206-214. In a study comprising 7033 patients with HL, the risk of death from myocardial infarction after treatment was shown to remain high for at least 25 years. The increased risks are related to supradiaphragmatic radiotherapy but may also be related to anthracycline and vincristine treatment.
8. Specht L, Gray RG, Clarke MJ, Peto R: Influence of more extensive radiotherapy and adjuvant chemotherapy on long-term outcome of early-stage Hodgkin's disease: a meta-analysis of 23 randomized trials involving 3,888 patients. International Hodgkin's Disease Collaborative Group. J Clin Oncol 1998, 16:830-843.
9. Engert A, Schiller P, Josting A, et al.: Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol 2003, 21:3601-3608.
10. Diehl V, Brillant C, Engert A, et al.: HD10: Investigating reduction of combined modality treatment intensity in early stage Hodgkin's lymphoma. Interim analysis of a randomized trial of the German Hodgkin Study Group (GHSG) [abstract]. J Clin Oncol 2005, 23:Abstract 6506.
11. Noordijk E, Thomas J, Fermé C, et al.: First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin's lymphoma (HL) [abstract]. J Clin Oncol 2005, 23:Abstract 6505.
12. • Meyer RM, Gospodarowicz MK, Connors JM, et al.: Randomized comparison of ABVD chemotherapy with a strategy that includes radiation therapy in patients with limited-stage Hodgkin's lymphoma: National Cancer Institute of Canada Clinical Trials Group and the Eastern Cooperative Oncology Group. J Clin Oncol 2005, 23:4634-4642. In a randomized study evaluating patients with limited-stage HL (n = 399), no difference in overall survival was detected between patients randomly assigned to receive treatment that included radiotherapy or ABVD alone. Although 5-year freedom from disease progression was superior in patients receiving radiotherapy, this advantage was offset by deaths due to causes other than progressive HL or acute treatment-related toxicity.
13. Loeffler M, Brosteanu O, Hasenclever D, et al.: Meta-analysis of chemotherapy versus combined modality treatment trials in Hodgkin's disease. International Database on Hodgkin's Disease Overview Study Group. J Clin Oncol 1998, 16:818-829.
14. Diehl V, Franklin J, Pfreundschuh M, et al.: Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin's disease. N Engl J Med 2003, 348:2386-2395.
15. Aleman BM, Raemaekers JM, Tirelli U, et al.: Involved-field radiotherapy for advanced Hodgkin's lymphoma. N Engl J Med 2003, 348:2396-2406.
16. Aleman BM, Raemaekers JM, Tomsk R, et al.: Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys 2007, 67:19-30.
17. Tubiana M, Henry-Amar M, Werf-Messing B, et al.: A multivariate analysis of prognostic factors in early stage Hodgkin's disease. Int J Radiat Oncol Biol Phys 1985, 11:23-30.
18. Proctor SJ, Taylor P, Mackie MJ, et al.: A numerical prognostic index for clinical use in identification of poor-risk patients with Hodgkin's disease at diagnosis. The Scotland and Newcastle Lymphoma Group (SNLG) Therapy Working Party. Leuk Lymphoma 1992, 7(suppl):17-20.
19. Hasenclever D, Diehl V: A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med 1998, 339:1506-1514.
20. van Leeuwen FE, Klokman WJ, Stovall M, et al.: Roles of radiation dose, chemotherapy, and hormonal factors in breast cancer following Hodgkin's disease. J Natl Cancer Inst 2003, 95:971-980.
21. Travis LB, Hill DA, Dores GM, et al.: Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA 2003, 290:465-475.
22. Kremer LC, van Dalen EC, Offringa M, et al.: Anthracycline-induced clinical heart failure in a cohort of 607 children: long-term follow-up study. J Clin Oncol 2001, 19:191-196.
23. • Moser EC, Noordijk EM, van Leeuwen FE, et al.: Long-term risk of cardiovascular disease after treatment for aggressive non-Hodgkin's lymphoma. Blood 2005, 107:2912-2919. In a retrospective study including 476 patients treated with anthracycline-containing chemotherapy, it was shown that patients are at long-term high risk of chronic heart failure after treatment for non-Hodgkin's lymphoma. In contrast, the risk of coronary artery disease appeared more age-dependent than treatment-related.
24. Ng AK, Li S, Neuberg D, et al.: Long-term results of a prospective trial of mantle irradiation alone for early-stage Hodgkin's disease. Ann Oncol 2006, 17:1693-1697.
25. • Noordijk EM, Carde P, Dupouy N, et al.: Combined-modality therapy for clinical stage I or II Hodgkin's lymphoma: long-term results of the European Organisation for Research and Treatment of Cancer H7 randomized controlled trials. J Clin Oncol 2006, 24:3128-3135. A treatment strategy for early-stage HL based on prognostic factors leads to high overall survival rates in patients with both favorable and unfavorable prognosis. In patients with a favorable prognosis, the combination of mild EBVP chemotherapy and IF-RT can replace subtotal nodal irradiation as standard treatment. With an unfavorable prognosis, EBVP is significantly less efficient than MOPP/ABV.
26. Henry-Amar M, Hayat M, Meerwaldt JH, et al.: Causes of death after therapy for early stage Hodgkin's disease entered on EORTC protocols. EORTC Lymphoma Cooperative Group. Int J Radiat Oncol Biol Phys 1990, 19:1155-1157.
27. • Klimm B, Eich HT, Haverkamp H, et al.: Poorer outcome of elderly patients treated with extended-field radiotherapy compared with involved-field radiotherapy after chemotherapy for Hodgkin's lymphoma: an analysis from the German Hodgkin Study Group. Ann Oncol 2007, 18:357-363. Elderly patients with early-stage unfavorable HL (who generally have a poorer risk profile and outcome than younger patients) were randomized to receive four cycles of chemotherapy followed by either EF-RT or IF-RT. Treatment with EF-RT instead of IF-RT after chemotherapy has a negative impact on the survival of elderly patients and should be avoided.
28. Girinsky T, van der Maazen R, Specht L, et al.: Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol 2006, 79:270-277.
29. Shahidi M, Kamangari N, Ashley S, et al.: Site of relapse after chemotherapy alone for stage I and II Hodgkin's disease. Radiother Oncol 2006, 78:1-5.
30. Fermé C, Mounier N, Divine M, et al.: Intensive salvage therapy with high-dose chemotherapy for patients with advanced Hodgkin's disease in relapse or failure after initial chemotherapy: results of the Groupe d'Etudes des Lymphomes de l'Adulte H89 Trial. J Clin Oncol 2002, 20:467-475.
31. Sureda A, Arranz R, Iriondo A, et al.: Autologous stem-cell transplantation for Hodgkin's disease: results and prognostic factors in 494 patients from the Grupo Espanol de Linfomas/Transplante Autologo de Medula Osea Spanish Cooperative Group. J Clin Oncol 2001, 19:1395-1404.
32. Wendland MM, Asch JD, Pulsipher MA, et al.: The impact of involved field radiation therapy for patients receiving high-dose chemotherapy followed by hematopoietic progenitor cell transplant for the treatment of relapsed or refractory Hodgkin disease. Am J Clin Oncol 2006, 29:189-195.
33. Josting A, Nogova L, Franklin J, et al.: Salvage radiotherapy in patients with relapsed and refractory Hodgkin's lymphoma: a retrospective analysis from the German Hodgkin Lymphoma Study Group. J Clin Oncol 2005, 23:1522-1529.
34. Behringer K, Josting A, Schiller P, et al.: Solid tumors in patients treated for Hodgkin's disease: a report from the German Hodgkin Lymphoma Study Group. Ann Oncol 2004, 15:1079-1085.
35. • Hutchings M, Loft A, Hansen M, et al.: Clinical impact of FDG-PET/CT in the planning of radiotherapy for early-stage Hodgkin lymphoma. Eur J Haematol 2007, 78:206-212. The potential impact of FDG-PET/CT in the planning of IF-RT was studied. When used for radiotherapy planning, FDG-PET/CT results in larger IF-RT treatment volumes. If FDG-PET/CT is introduced to radiotherapy planning, it should be accompanied by a change in strategy, aiming at more targeted therapy to best avoid radiation to normal tissues.
36. Aleman BM, Girinsky T, van der Maazen RW, et al.: Quality control of involved-field radiotherapy in patients with advanced Hodgkin's lymphoma (EORTC 20884). Int J Radiat Oncol Biol Phys 2005, 63:1184-1190.
37. Dühmke E, Diehl V, Loeffler M, et al.: Randomized trial with early-stage Hodgkin's disease testing 30 Gy vs. 40 Gy extended field radiotherapy alone. Int J Radiat Oncol Biol Phys 1996, 36:305-310.
38. • Eich HT, Staar S, Gossmann A, et al.: Centralized radiation oncologic review of cross-sectional imaging of Hodgkin's disease leads to significant changes in required involved field - results of a quality assurance program of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 2004, 58:1121-1127. The feasibility of a quality assurance program for patients treated for HL (including IF-RT) was tested. The program included central prospective radiation oncologic review of all patients' diagnostic imaging and clinical findings and an individual radiotherapy prescription. The study showed that a central prospective review of patient data and prescription of individual radiotherapy treatment volume is feasible within large multicenter trials for HL and may have significant impact on the correctness of staging, allocation to treatment groups, and extent of the IF-RT treatment volume.
39. Montalban C, Garcia JF, Abraira V, et al.: Influence of biologic markers on the outcome of Hodgkin's lymphoma: a study by the Spanish Hodgkin's Lymphoma Study Group. J Clin Oncol 2004, 22:1664-1673.
40. Diehl V, Stein H, Hummel M, et al.: Hodgkin's lymphoma: biology and treatment strategies for primary, refractory, and relapsed disease. Hematology (Am Soc Hematol Educ Program) 2003, 225-247.
41. Eghbali H, Raemaekers J, Carde P: The EORTC strategy in the treatment of Hodgkin's lymphoma. Eur J Haematol Suppl 2005, 135-140.
42. Straus DJ, Portlock CS, Qin J, et al.: Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease. Blood 2004, 104:3483-3489.
43. Canellos GP, Anderson JR, Propert KJ, et al.: Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med 1992, 327:1478-1484.
44. Duggan DB, Petroni GR, Johnson JL, et al.: Randomized comparison of ABVD and MOPP/ABV hybrid for the treatment of advanced Hodgkin's disease: report of an intergroup trial. J Clin Oncol 2003, 21:607-614.
45. Fabian CJ, Mansfield CM, Dahlberg S, et al.: Low-dose involved field radiation after chemotherapy in advanced Hodgkin disease. A Southwest Oncology Group randomized study. Ann Intern Med 1994, 120:903-912.
46. Fermé C, Sebban C, Hennequin C, et al.: Comparison of chemotherapy to radiotherapy as consolidation of complete or good partial response after six cycles of chemotherapy for patients with advanced Hodgkin's disease: results of the Groupe d'Etudes des Lymphomes de l'Adulte H89 trial. Blood 2000, 95:2246-2252.
47. Fermé C, Mounier N, Casasnovas O, et al.: Long-term results and competing risk analysis of the H89 trial in patients with advanced-stage Hodgkin lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte (GELA). 2006, 107:4636-4642.
48. Horning SJ, Williams J, Bartlett NL, et al.: Assessment of the Stanford V regimen and consolidative radiotherapy for bulky and advanced Hodgkin's disease: Eastern Cooperative Oncology Group pilot study E1492. J Clin Oncol 2000, 18:972-980.
49. Diehl V, Brillant C, Franklin J, et al.: BEACOPP chemotherapy for advanced Hodgkin's disease: results of further analyses of the HD9- and HD12- Trials of the German Hodgkin Study Group (GHSG) [abstract]. Blood (ASH Annual Meeting Abstracts) 2004, 104:Abstract 307.
50. Radford JA, Rohatiner AZ, Ryder WD, et al.: ChlVPP/EVA hybrid versus the weekly VAPEC-B regimen for previously untreated Hodgkin's disease. J Clin Oncol 2002, 20:2988-2994.
51. Gobbi PG, Levis A, Chisesi T, et al.: ABVD versus modified Stanford V versus MOPPEBVCAD with optional and limited radiotherapy in intermediate- and advanced-stage Hodgkin's lymphoma: final results of a multicenter randomized trial by the Intergruppo Italiano Linfomi. J Clin Oncol 2005, 23:9198-9207.