Randomized trial with early-stage Hodgkin's disease testing 30 Gy vs. 40 Gy extended field radiotherapy alone

Dühmke, Eckhart; Diehl, Volker; Loeffler, Markus; Mueller, Rolf‐Peter; Ruehl, U.; Willich, N.; Georgii, A.; Roth, Stephan; Matthaei, D.; Sehlen, Susanne; Brosteanu, Olga; Hasenclever, Dirk; Wilkowski, Ralf; Becker, Klaus

doi:10.1016/s0360-3016(96)00333-1

Cited by 73 publications

(18 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dühmke et al (18) showed a significant influence on the quality of RT and the outcome of patients in early stages of HL (HD4 trial). A 5-year freedom from treatment failure rate of 70% after major violations versus 82% after correct RT was reported.…”

Section: Discussionmentioning

confidence: 99%

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Kříž

Reinartz

Dietlein

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Kříž

Reinartz

Dietlein

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

“…Furthermore, a detailed analysis of documented relapses in correlation with the performed RT was conducted. One important achievement of these activities in the era of EF-RT was to show that deviations of radiation treatment portals and radiation doses from prospective treatment prescriptions proved to be unfavorable prognostic factors for patients with early stage HL ( Figure 1) [4,5].…”

Section: Introductionmentioning

confidence: 99%

The Development of Quality Assurance Programs for Radiotherapy within the German Hodgkin Study Group (GHSG)

Müller

Eich

2005

Strahlenther Onkol

View full text Add to dashboard Cite

Today, radiation oncologists in the GHSG perform a continuous and efficient QAP to improve treatment quality of study patients. For early favorable and unfavorable HL a central prospective review of all diagnostic imaging is performed by expert radiation oncologists to control the disease extension and to define the IF treatment volume. Retrospective analysis of RT portals by an expert panel detects faults in the applied irradiation. Participants are trained on the definition of IF-RT by workshops on the occasion of annual GHSG meetings and on the annual meetings of the German Society of Therapeutic Radiation Oncology (DEGRO). For the advanced stages a multidisciplinary panel evaluates the treatment response to chemotherapy. Patients with a poor response receive additional RT due to the panel's recommendation. The introduction of teleradiotherapy into the GHSG trials improves the dialogue between the central RT reference center and study participants and thus contributes to high RT quality for study patients.

show abstract

“…In 44 replies the mediastinal coverage was judged to be inadequate in at least 50% of the cases (57). The GHSG (German Hodgkin Study Group) conducted a randomized multicentre study between 1988 and 1993 with different radiation doses in patients with earlystage HL treated with radiotherapy only (15). A panel of four experienced chairpersons from different departments of radiation therapy prospectively reviewed the planning and verification films, the radiotherapy reports charts, the technique and the dosimetry.…”

Section: Radiation As Salvage Therapymentioning

confidence: 99%

A Systematic Overview of Radiation Therapy Effects in Hodgkin's Lymphoma

2003

View full text Add to dashboard Cite

A systematic review of radiation therapy trials in several tumour types was carried out by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately (Acta Oncol 2003; 42: 357-365). This synthesis of the literature on radiation therapy for Hodgkin's lymphoma (HL) is based on data from 12 randomized trials and 2 meta-analyses. Data from 3 prospective studies, 29 retrospective studies and 58 other articles were also used. In total, 58 scientific articles are included, involving 27,280 patients. The results were compared with those of a similar overview from 1996 including 38,362 patients. The conclusions reached can be summarized thus: Solid scientific documentation shows that in patients with HL more than 80% in the early stages and 60-70% of younger patients in advanced stages of disease are now cured by the development of radiotherapy and combination chemotherapy. Long-term follow-up shows that after 15 to 20 years the mortality from HL in early and intermediate stages is exceeded by other causes of death, mostly secondary malignancies and cardiac deaths, especially myocardial infarction. Convincing data show that radiotherapy plays a major role in the development of solid cancers and cardiovascular disease, but no randomized trials have been performed. During the past decade increasing awareness of fatal long-term sequelae has fundamentally changed treatment strategies in early and intermediate stages. A thorough long-term follow-up is essential to evaluate the effects of the modifications of the therapy. In early stages of disease extended field irradiation is now replaced by short periods of chemotherapy followed by limited radiotherapy to decrease late sequelae. This approach is strongly supported by early reports from randomized trials. Final results cannot be fully evaluated for many years. The optimal radiation dose and volume after chemotherapy are not defined or if irradiation is needed at all. Several studies are under way. In intermediate stages two recently reported randomized trials indicate that combined modality therapy is preferable and that involved field could replace extended field irradiation. It is still too early to draw any firm conclusions. In advanced stages, there is no evidence of any survival benefit from additional radiotherapy. The role of radiotherapy in the case of residual tumour and bulky disease still remains controversial. There is no scientific support for improved survival with radiotherapy in conjunction with high-dose chemotherapy with stem-cell support. Radiotherapy as salvage treatment might be an alternative in late limited nodal recurrence after initial chemotherapy. However, the body of knowledge is small. The role of radiotherapy in the treatment of HL is decreasing.

show abstract

Randomized trial with early-stage Hodgkin's disease testing 30 Gy vs. 40 Gy extended field radiotherapy alone

Cited by 73 publications

References 10 publications

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

The Development of Quality Assurance Programs for Radiotherapy within the German Hodgkin Study Group (GHSG)

A Systematic Overview of Radiation Therapy Effects in Hodgkin's Lymphoma

Contact Info

Product

Resources

About