Radiotherapy with concomitant BRAF inhibitor therapy is feasible with an acceptable increase in toxicity. Vemurafenib is a more potent radiosensitizer than dabrafenib.

Complementary and alternative medicine (CAM) is widely used by cancer patients. In order to learn more on the usage of CAM, its reasons and motifs as well as sources of information along the trajectory of treatment, we decided to evaluate the prevalence and predictors for the use of CAM by cancer patients while being under active treatment with chemo- or radiotherapy or in aftercare. We distributed a standardized questionnaire among patients attending a department of radio-oncology, an ambulance for oncology and offices of general practitioners (GPs). Five hundred and six patients took part. Most attributed cancer to stress and trauma (23.7 and 16.4 %) or genes (20.8 %). Forty-four percentage reported knowing a physician with competence in CAM, and in all settings, most patients named the GP. Fifty-one percentage admitted using CAM, 35 % informed the oncologist about using CAM, 56 % informed the GP, and 26 % did not inform any physician. Most often used CAM was vitamin D (17 %) and selenium (16 %). Most important goals were to strengthen the immune system (59 %) and become active (52 %). Most patients were satisfied with the CAM methods they used. Yet, with some methods, dissatisfaction was up to 30 %. The GP has an important function concerning CAM in oncology as most patients believe the GP to have best knowledge in CAM. In order to integrate complementary medicine into evidence-based medicine, physicians should be trained on how to communicate on CAM with the patient and with each other. Explaining cancer and cancer therapies in a way lay persons are able to understand may be helpful. Physicians should actively address patients' needs of involvement not only in decision making, but also actively in the therapy.

Elderly patients with early-stage unfavorable HL generally have a poorer risk profile and outcome when compared with younger patients. Treatment with EF-RT instead of IF-RT after chemotherapy has a negative impact on survival of elderly patients and should be avoided.

Background: In our HD16 study for early-stage favorable Hodgkin lymphoma (HL), we used PET after 2 cycles of ABVD to guide involved-field radiotherapy (IFRT). As in our parallel HD18 trial, we defined a Deauville score (DS) 3 as positive. However, HD18 showed that DS3 did not indicate an increased risk of treatment failure in advanced-stage HL, while DS4 added prognostic information to baseline risk factors. Aims: We investigated whether these results also hold true in the context of early-stage favorable HL patients treated with ABVD and IFRT in our international HD16 trial (NCT00736320). Methods: Between November 2009 and December 2015, we recruited 1150 patients with newly diagnosed, early-stage favorable HL aged 18-75 years from Germany, Switzerland, Austria, and the Netherlands for this randomized, parallel-group phase 3 trial. Patients were randomly assigned to receive standard combined-modality treatment (CMT) with 2xABVD and 20 Gy IFRT or PET-guided treatment, where IFRT was restricted to patients with DS 3 after 2xABVD. PET was centrally assessed by an expert panel blinded towards the randomization result. A central objective of the trial was to prospectively test whether a DS 3 was associated with impairment in progression-free survival (PFS) among patients treated with CMT (i.e. those randomized to the standard group and those from the PET-guided randomization group with DS 3). We also explored the association of DS with baseline characteristics and treatment outcomes considering different cutoffs for positivity. We analyzed survival outcomes according to Kaplan-Meier, using Cox regression for comparisons. Results: Among 1007 randomized patients with regular PET, 667 (66%), 218 (22%) and 122 (12%) had DS 1-2, 3 and 4, respectively. Of those, 693 were assigned to treatment with CMT (353, 3 and 4, respectively). Clinical stage II and bulky disease at initial staging were associated with an unfavorable DS after 2xABVD. CT-based complete remission as final treatment outcome after IFRT was observed in 344/348 patients (99%) with interim DS1-2, 209/214 (98%) with DS3, and 108/117 (92%) with DS4 (p = 0.016 for DS1-2 vs. 3-4; p = 0.0012 for DS1-3 vs. 4). Of note, all six progressions in this trial occurred in the DS4 subgroup. With a median follow-up of 46 months, the estimated 5-year PFS was 93.2% (90.2-96.2) among patients with DS1-2, 92.8% (88.8-96.9) for those with DS3 and only 80.9% (72.2-89.7) in the DS4 subgroup. Considering DS 3 as cutoff, the PFS difference was just statistically significant ], p = 0.047). An analysis adjusting for baseline stratification factors led to similar, but non-significant results ], p = 0.055). With DS4 as cutoff, the difference became more pronounced, indicating a threefold risk for treatment failure in patients with DS4 after chemotherapy (HR adjusted for baseline factors 2. 94 [1.63-5.31], p = 0.0004). Overall survival was on a high level with no differences between any subgroups defined by DS (5-year overall survival 98.