Further chemotherapy versus low-dose involved-field radiotherapy as consolidation of complete remission after six cycles of alternating chemotherapy in patients with advanced Hodgkin's disease

Abstract

No statistically significant differences in treatment efficacy were detected between 20 Gy IF radiotherapy and 1X (COPP + ABVD) chemotherapy following CR after six cycles of alternating chemotherapy in patients with advanced-stage HD. However, limited observations in a non-randomized cohort indicate that patients without consolidation treatment of CR after 6 cycles of chemotherapy may have an elevated risk of relapse.

18F-FDG PET After 2 Cycles of ABVD Predicts Event-Free Survival in Early and Advanced Hodgkin Lymphoma

“…Current therapies fail to cure about one third of patients with HL, and a similar proportion of patients may be overtreated (18)(19)(20). A precise early-prediction tool of response to therapy should be able to discriminate patients who could be cured with conventional therapy or even less intensive or toxic regimens from patients who need to switch to more aggressive treatment strategies that could improve outcome.…”

Evolving Approaches to Primary Treatment of Hodgkin Lymphoma

“…Three subsequently reported randomized trials examined the usefulness of radiation for patients in complete remission after chemotherapy for advanced-stage Hodgkin lymphoma and found no significant impact. [23][24][25] Although one study of similar design showed contradictory results, it primarily focused on pediatric patients and patients with limited-stage disease. 26 Overall, the negative long-term effects of radiation appear to outweigh any benefits for the usual patient with ad- vanced-stage disease.…”

State of the Art Therapy of Advanced Hodgkin Lymphoma

“…With a median follow-up of eight years, there were no statistically significant differences in relapsefree or overall survival (Fabian et al 1994). The GHSG randomized patients with stage III or IV disease in complete remission by computed tomographic assessment after six cycles of COPP/ABVD to two more cycles of chemotherapy or low-dose (20 Gy) IFRT, and this study demonstrated no difference in relapse rate between the two arms (Diehl et al 1995). A GELA study assessed the role of more extensive radiotherapy (subtotal nodal or total) versus two more cycles of chemotherapy in stage III/IV patients having achieved a complete or very good partial remission (≥ 75% size reduction) with six cycles of either MOPP/ABV or ABVPP.…”