Display options
Share it on

J Blood Med. 2015 Mar 20;6:87-92. doi: 10.2147/JBM.S69267. eCollection 2015.

The benefit of consolidation radiotherapy to initial disease bulk in patients with advanced Hodgkin's disease who achieved complete remission after standard chemotherapy.

Journal of blood medicine

Yasser Bayoumi, Abdulaziz Al-Homaidi, Syed Zaidi, Imran Tailor, Ibrahiem Motiabi, Nawal Alshehri, Assem Al-Ghazali, Samer Almudaibigh

Affiliations

  1. Radiation Oncology, National Cancer Institute, Cairo University, Egypt ; Radiation Oncology Department, King Fahad Medical City, Riyadh, Saudi Arabia.
  2. Department of Haematology and Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.

PMID: 25848329 PMCID: PMC4374789 DOI: 10.2147/JBM.S69267

Abstract

BACKGROUND/PURPOSE: The aim of this study was to evaluate the role of consolidation radiotherapy (RT) in advanced-stage Hodgkin's disease (HD) with initial bulky sites after radiological complete remission (CR) or partial response (PR) with positron emission tomography-negative (metabolic CR) following standard chemotherapy (ABVD [Adriamycin, bleomycin, vinblastine, and dacarbazine]) six to eight cycles.

PATIENTS AND METHODS: Adult patients with advanced-stage HD treated at our institute during the period 2006 to 2012 were retrospectively evaluated. One hundred and ninety-two patients with initial bulky disease size (>7 cm) who attained radiological CR/PR and metabolic CR were included in the analysis. One hundred and thirteen patients who received radiotherapy (RT) as consolidation postchemotherapy (RT group) were compared to 79 patients who did not receive RT (non-RT group). Disease-free (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method and were compared according to treatment group by the log-rank tests at P ≤0.05 significance level.

RESULTS: The mean age of the cohort was 33 (range: 14 to 81) years. Eighty-four patients received involved-field radiation and 29 patients received involved-site RT. The RT group had worse prognostic factors compared to the non-RT group. Thirteen (12%) relapses occurred in the RT group, and 19 (24%) relapses occurred in the non-RT group. Nine patients (8%) in the RT group died, compared to eleven patients (14%) in the non-RT group. Second malignancies were seen in only five patients: three patients in the RT group compared to two patients in the non-RT group. At 5 years, overall DFS was 79%±9% and OS was 85%±9%. There was significant statistical difference between the RT group and the non-RT group regarding 5-year DFS: 86%±7% and 74%±9%, respectively (P ≤0.02). However, the 5-year OS was 90%±5% for the RT group and 83%±8% for the non-RT group, with no statistical difference (P ≤0.3).

CONCLUSION: The results of our study suggest that consolidation RT in patients with advanced-stage HD with initial bulky disease who had postchemotherapy radiologic CR or PR with metabolic CR improved the DFS.

Keywords: Hodgkin’s disease; involved-field radiation; involved-site radiation; radiological and metabolic complete remission

References

  1. Ann Intern Med. 1994 Jun 1;120(11):903-12 - PubMed
  2. Ann Oncol. 2002;13 Suppl 1:102-6 - PubMed
  3. J Clin Oncol. 2004 Jan 1;22(1):62-8 - PubMed
  4. Int J Radiat Oncol Biol Phys. 2001 Dec 1;51(5):1209-18 - PubMed
  5. J Clin Oncol. 2007 Feb 10;25(5):579-86 - PubMed
  6. J Clin Oncol. 2014 Apr 20;32(12 ):1188-94 - PubMed
  7. J Clin Oncol. 2002 Aug 15;20(16):3484-94 - PubMed
  8. J Clin Oncol. 2003 Jun 15;21(12):2320-5 - PubMed
  9. N Engl J Med. 2003 Jun 12;348(24):2396-406 - PubMed
  10. Cancer Invest. 1996;14(4):361-70 - PubMed
  11. J Clin Oncol. 2010 Jul 10;28(20):3352-9 - PubMed
  12. Ann Oncol. 2002;13 Suppl 1:96-7 - PubMed
  13. J Clin Oncol. 1998 Mar;16(3):818-29 - PubMed
  14. Radiat Oncol. 2006 Oct 02;1:38 - PubMed
  15. J Clin Oncol. 2001 Mar 1;19(5):1395-404 - PubMed
  16. J Clin Oncol. 1998 Dec;16(12):3810-21 - PubMed
  17. J Clin Oncol. 2002 Feb 1;20(3):630-7 - PubMed

Publication Types