Limited field Radiotherapy for Early Stage, Infra-diaphragmatic Hodgkin's Lymphoma

Harris, Margaret

doi:10.1016/j.clon.2003.08.007

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…PET-staged patients were older and the disease seemed to be less unfavorable, with less frequent stage II and less frequent central nodal involvement, lower levels of inflammatory parameters (ESR, hemoglobin) compared with CT-staged patients. In addition, PET-staged patients had a lower risk of relapse and a better outcome (PFS at 5-years at 78%) compared with previous reports, in which treatment failure ranged from 15% to 42% [ 5 - 7 , 10 , 12 ]. By contrast, in the SDHL series [ 29 ], the relapse rate ranged from only 5 to 10%, depending on the baseline risk factors.…”

Section: Discussionmentioning

confidence: 55%

“…As reported in previous IDHL series [ 2 , 4 , 5 , 7 , 10 , 12 , 21 ], nodal localizations were divided into central, including mesenteric and/or lumbar-aortic and/or iliac involvement, and peripheral, including inguinal and/or crural adenopathy.…”

Section: Methodsmentioning

confidence: 99%

“…As these patients are often excluded from clinical trials and few cases of IDHL are reported in most retrospective published series, no consensual standard treatment or prognostic factors have emerged for the management of these patients. In addition, most series of IDHL [ 2 - 11 ] were published when only CT-scan was available for the staging and patients were often treated with radiotherapy alone [ 1 , 3 , 6 - 12 ]. PET-CT has better sensitivity and is more accurate than CT for identifying HL localization, in particular extra-nodal involvement, and has been recommended for staging HL patients since 2007 (Cheson 2007) [ 13 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Infradiaphragmatic Hodgkin lymphoma: a large series of patients staged with PET-CT

et al. 2017

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IntroductionInfradiaphragmatic Hodgkin Lymphoma (IDHL) accounts for 3-11% of adult cases of stage I-II Hodgkin Lymphoma and the treatment strategy in IDHL is still heterogeneous. All previous published studies were conducted before the PET-CT era. PET may provide a more accurate evaluation of IDHL stage. The aim of this study was to analyze the clinical and biological characteristics of IDHL patients staged by CT scan or PET-CT in eight French hematology departments and their impact on outcomes in these patients.MethodsBaseline clinical and biological data and outcomes in patients with a first diagnosis of stage I-II IDHL treated with ABVD +/- radiotherapy were retrospectively collected.ResultsAmong the 99 patients included, 65 (66%) were staged with PET-CT. These patients were older (53 years vs 46 years, p=0.043), had lower ESR (27 vs 58mm, p=0.022), higher hemoglobin level (13.6 vs 12.8g/dL, p=0.015), less frequent Ann Arbor stage II (74% vs 91%) and less central adenopathy involvement (60% vs 82%, p=0.024). Treatment was chemotherapy alone in 55% of patients and the remaining patients received chemo-radiotherapy (CRT). Five-year PFS and OS rates in PET-CT-staged patients were 78% (95% CI 64-87) and 88% (95% CI 73-95), respectively, compared with 65% (p=0.225) and 82% (p=0.352) in CT-staged patients. The CRT strategy was associated with fewer relapses (p=0.027).ConclusionThis study showed that the characteristics of CT-staged IDHL patients were less favorable than those of PET-CT-staged patients and indicated that CRT provided better PFS than did chemotherapy alone.

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