Impact of 18F-Fluoro-2-Deoxyglucose Positron Emission Tomography on Treatment Strategy and Radiotherapy Planning for Stage I–II Hodgkin Disease: A Prospective Multicenter Study

Pommier, P.; Dussart, Sophie; Girinsky, T.; Chabaud, Sylvie; Lagrange, J. L.; Nguyen, Tan Dat; Beckendorff, V.; d’Hombres, A.; Artignan, Xavier; Bondiau, P.-Y.; Carrié, C.; Giammarile, Francesco

doi:10.1016/j.ijrobp.2009.11.048

Cited by 28 publications

(12 citation statements)

References 17 publications

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“…Thus, radiation therapy should be studied in this new context, and cannot be considered a standard of care until its benefit is proven. Some studies have recently addressed the role of radiation therapy in the management of localized disease in patients with positive Positron Emission Tomography (PET) after chemotherapy [43-45]. Radiation therapy yielded interesting survival results in this subset of patients, providing a rational selection tool for consolidative radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Is there a role for consolidative radiotherapy in the treatment of aggressive and localized Non-Hodgkin Lymphoma? A systematic review with meta-analysis

Santos

Lima

et al. 2012

BMC Cancer

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Background Chemotherapy is the mainstay of non-Hodgkin lymphoma (NHL) treatment. Based on expert opinion, the use of radiotherapy (RT) is currently preferred in some institutions as consolidative treatment for patients with localized disease. The lack of conclusive data coming from conflicting studies about the impact of treatment demands a systematic review, which could provide the most reliable assessment for clinical decision-making. We evaluate the addition of RT post-CT, for aggressive and localized NHL (ALNHL). Methods Randomized controlled trials (RCT) that evaluated chemotherapy alone versus chemotherapy plus RT were searched in databases. The outcomes were overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and toxicity. Risk ratio (RR) and hazard ratio (HR) with their respective 95% confidence intervals (CI) were calculated using a fized-effect model. Results Four trials (1,796 patients) met the inclusion criteria. All trials tested the use of RT after systemic therapy comprising anthracycline-based chemotherapy. This systematic review showed that RT enhances PFS after chemotherapy (hazard ratio [HR] 0.81; 95% CI 0.67-0.98; p = 0.03), with no impact on ORR and OS. Some heterogeneity between trials could limit the conclusions about OS. Toxicity data could not be pooled due to differences in reporting adverse events. Conclusions This systematic review with meta-analysis shows no improvement in survival when adding RT to systemic therapy for ALNHL. Our conclusions are limited by the available data. Further evaluations of new RT technologies and its association with biologic agents are needed.

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Section: Discussionmentioning

confidence: 99%

Is there a role for consolidative radiotherapy in the treatment of aggressive and localized Non-Hodgkin Lymphoma? A systematic review with meta-analysis

Santos

Lima

et al. 2012

BMC Cancer

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“…Multiple studies have now demonstrated that PET/CT treatment planning can affect tumor-volume definition and management in lymphoma patients [8,9,27–30]. For example, in a study of 30 patients with early stage HL who received a staging PET/CT and chemoradiation, integration of PET information into IFRT planning would have increased the treated volume in seven patients and decreased it in two [27].…”

Section: Radiation Planning and Advanced Radiation Treatment Technmentioning

confidence: 99%

“…In a prospective multi-center study of 137 early stage HL patients, RT was cancelled in 4.8% and the treatment plan was modified in 13% based on information from pre-radiotherapy PET. Overall, the concordance in treatment strategy with or without pre-radiotherapy PET was 82% [30]. Because PET/CT for radiation planning may at times result in an increase in treatment volume, PET for fusion in RT planning must be cautiously applied as concerns for late effects are paramount.…”

Section: Radiation Planning and Advanced Radiation Treatment Technmentioning

confidence: 99%

Tailored strategies for radiation therapy in classical Hodgkin's lymphoma

Terezakis

Kasamon

2012

Critical Reviews in Oncology/Hematology

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“…Accuracy is improved by using PET co-registered with the planning CT scans. 47 Pre-RT PET for treatment planning may lead to significant modifications of RT treatment strategy including clinical target volume and total dose 48…”

Section: Combined Modality Therapy In Early Hlmentioning

confidence: 99%

Hodgkin's lymphoma therapy: past, present, and future

Rathore

Kadin

2010

Expert Opinion on Pharmacotherapy

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Importance of the field-The treatment of Hodgkin lymphoma (HL) with the use of radiotherapy and systemic chemotherapy has been one of the success stories of modern oncology. HL therapy has been the paradigm for the systematic evaluation of different curative modalities resulting in cure for the majority of patients. The current focus is on designing initial therapeutic strategies which retain efficacy and minimize long-term toxicity. Appropriate use of pathologic, clinical, biologic and radiologic prognostic factors in identification of aggressive HL is paramount in designing a successful therapeutic strategy.Areas covered in this review-This review addresses the current and future use of prognostic tools, including PET scanning and other biomarkers, in identifying patients with aggressive HL with reference to publications from the last two decades. The current standard approaches with the use of combined modality therapy and systemic chemotherapy as well as the promising role of future response-adapted strategies is reviewed.What the reader will gain-The reader will obtain a comprehensive review of risk assessment strategies as well as current and investigational therapeutic approaches in the management of HL.Take home message-In HL, appropriate utilization of risk assessment strategies is required to maximize therapeutic outcomes while minimizing toxicity, especially long-term toxicity. Responseadapted therapy utilizing PET has the potential to profoundly improve the therapeutic landscape in HL.

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Impact of 18F-Fluoro-2-Deoxyglucose Positron Emission Tomography on Treatment Strategy and Radiotherapy Planning for Stage I–II Hodgkin Disease: A Prospective Multicenter Study

Cited by 28 publications

References 17 publications

Is there a role for consolidative radiotherapy in the treatment of aggressive and localized Non-Hodgkin Lymphoma? A systematic review with meta-analysis

Is there a role for consolidative radiotherapy in the treatment of aggressive and localized Non-Hodgkin Lymphoma? A systematic review with meta-analysis

Tailored strategies for radiation therapy in classical Hodgkin's lymphoma

Hodgkin's lymphoma therapy: past, present, and future

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