Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.

Cutuli, B.; Petit, Thomas; Hoffstetter, S.; Velten, M; Dufour, P.; Girón, Carlos García; Léderlin, P.; Jung, G.M.; Bergerat, Jean‐Pierre; Maloisel, Frédéric; Bey, P.; Oberling, F.

doi:10.3892/or.5.6.1513

Cited by 3 publications

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“…Chemo-radiotherapy might therefore be more efficient to control the disease. None of the previous studies focusing on IDHL found this difference, perhaps because of the small number of patients included [ 3 , 8 - 11 , 32 ]. In SDHL, two large randomized phase III trials (the RAPID trial [ 33 ] and the H10 trial [ 34 ]) underlined the importance of radiotherapy consolidation to reduce the risk of relapse.…”

Section: Discussionmentioning

confidence: 88%

“…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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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…There are controversial results about the prognosis of IDHL in comparison to stage I/II supradiaphragmatic disease in the literature. All the studies compared them with their classical prognostic factors with limited numbers of patients and different treatment approaches 10,12,15 . After evaluation of all potential risk factors affecting metastasis/recurrence with univariate cox regression analysis and multivariate model sex, TLG and bulky disease were found to be statistically significant risk factors for disease free survival time in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Although important subjects about prognostic factors and optimal treatment of isolated infradiaphragmatic HL have not been clearly determined, it is know that IDHL is characterized by higher male/female ratio, older patients' age at diagnosis and higher prevalence of lymphocyte-predominant histologic subtype in relation to supradiaphragmatic HL [8][9][10][11][12][13] . Whether pure infradiaphragmatic localization has a worse prognosis than stage I/II supradiaphragmatic disease has still remained controversial 9,[14][15][16][17] . Most studies pertaining to IDHL contain limited numbers of patients with different trea-tment approaches and varying outcomes roughly along a mean of 20-year follow-up 18,19 .…”

Section: Introductionmentioning

confidence: 99%

Prognostic importance of metabolic tumor parameters on initial FDG-PET/CT in patients with isolated infradiaphragmatic Hodgkin’s lymphoma

et al. 2017

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Background/Aim. Isolated infradiaphragmatic lymph node involvement is not common and makes up 5-13% of stage I-II Hodgkin's lymphoma. Important subjects about prognostic factors and optimal treatment of isolated infradiaphragmatic Hodgkin's lymphoma (II HL) have not been clearly defined. We aimed to evaluate the prognostic value of metabolic tumor indices on initial 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) through quantitative PET/CT parameters together with the classical predefined risk factors for patients with II HL. Methods. This retrospective cohort study conducted between 2004 and 2015 included 21 patients for whom FDG-PET/CT were requested for primary staging. Quantitative PET/CT parameters (maximum standardized uptake value-SUV max) average standardized uptake value-SUV mean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival. Results. Univariate Cox regression analysis was performed for all potential risk factors impacting metastasis/recurrence of the disease. Factors which had values of p < 0.2 after univariate analysis (sex, age, stage, bulky disease, SUV max, SUV mean, MTV, TLG) were processed with the multivariate model. Sex, TLG and bulky disease were found to be statistically significant risk factors for prognosis of outcome in patients with IIHL after multivariate analysis. Conclusion. The existence of bulky disease at the diagnosis and high TLG values on primary staging by FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in Hodgkin's lymphoma with isolated infradiaphragmatic lymph node involvement.

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

Harris¹

2004

Clinical Oncology

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Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.

Cited by 3 publications

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

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

Prognostic importance of metabolic tumor parameters on initial FDG-PET/CT in patients with isolated infradiaphragmatic Hodgkin’s lymphoma

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

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