Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease.

@article{Ferme2007ChemotherapyPI,
  title={Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease.},
  author={Christophe Fermé and Houchingue Eghbali and Jacobus H. Meerwaldt and Chantal Rieux and Jacques Bosq and Françoise Berger and Th{\'e}odore Girinsky and Pauline Brice and Mars B van't Veer and Jan Walewski and Pierre Lederlin and Umberto Tirelli and Patrice Carde and Eric W Van Den Neste and Emmanuel Gyan and Mathieu Monconduit and Marine Divin{\'e} and John M. M. Raemaekers and Gilles Andr{\'e} Salles and Evert M. Noordijk and Geert-Jan M. Creemers and Jean Gabarre and Anton Hagenbeek and Oum{\'e}daly Reman and Michel Blanc and Jos{\'e} Thomas and Brigitte Vi{\'e} and Johanna C Kluin-Nelemans and F. Viseu and Joke W. Baars and Philip M Poortmans and Pieternella J. Lugtenburg and Christian Carrie and J{\'e}r{\^o}me Jaubert and Michel Henry-Amar},
  journal={The New England journal of medicine},
  year={2007},
  volume={357 19},
  pages={
          1916-27
        }
}
BACKGROUND Treatment of early-stage Hodgkin's disease is usually tailored in line with prognostic factors that allow for reductions in the amount of chemotherapy and extent of radiotherapy required for a possible cure. METHODS From 1993 to 1999, we identified 1538 patients (age, 15 to 70 years) who had untreated stage I or II supradiaphragmatic Hodgkin's disease with favorable prognostic features (the H8-F trial) or unfavorable features (the H8-U trial). In the H8-F trial, we compared three… 

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Radiotherapy in early stage classical Hodgkin lymphoma: past, present and future.

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Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma.

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In patients with early-stage Hodgkin's lymphoma and a favorable prognosis, treatment with two cycles of ABVD followed by 20 Gy of involved-field radiation therapy is as effective as, and less toxic than, four cycles ofABVD following by 30 Gy ofinvolved- field radiation therapy.

Results of a trial of PET-directed therapy for early-stage Hodgkin's lymphoma.

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Patients with early-stage Hodgkin's lymphoma and negative PET findings after three cycles of ABVD had a very good prognosis either with or without consolidation radiotherapy, and the noninferiority of the strategy of no further treatment after chemotherapy with regard to progression-free survival did not show.

Radiation therapy for early stage unfavorable Hodgkin lymphoma: is dose reduction feasible?

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Four cycles of ABVD and reduced dose IFRT resulted in optimal outcomes and there were no in-field relapses in patients with bulky disease receiving RT doses > 25.2 Gy.

Response-guided ABVD chemotherapy plus involved-field radiation therapy for intermediate-stage Hodgkin lymphoma in the pre-positron emission tomography era: a Gruppo Italiano Studio Linfomi (GISL) prospective trial.

TLDR
The response-guided ABVD program, based on standard clinical staging procedures, proved to be feasible and safe in patients with intermediate-stage Hodgkin lymphoma.
...

References

SHOWING 1-10 OF 22 REFERENCES

Combined-modality therapy for clinical stage I or II Hodgkin's lymphoma: long-term results of the European Organisation for Research and Treatment of Cancer H7 randomized controlled trials.

TLDR
A treatment strategy for early-stage HL based on prognostic factors leads to high OS rates in both favorable and unfavorable patients, and in favorable patients, the combination of EBVP and IF-RT can replace STNI as standard treatment.

ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results.

TLDR
Present long-term findings suggest that, after four cycles of ABVD, I FRT can achieve a worthwhile outcome, and ABVD followed by IFRT can be considered an effective and safe modality in early Hodgkin's disease with both favorable and unfavorable presentation.

Intermediate stage Hodgkin's disease: preliminary results on 210 patients treated with four ABVD chemotherapy cycles plus extended versus involved field radiotherapy.

TLDR
The efficacy of four cycles of ABVD regimen, with suitable dose intensity, and radiotherapy as consolidation therapy, and involved field radiotherapy results were as effective as extended field, without acute toxicity.

Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group.

  • A. EngertP. Schiller V. Diehl
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2003
TLDR
Radiotherapy volume size reduction from EF to IF after COPP + ABVD chemotherapy for two cycles produces similar results and less toxicity in patients with early-stage unfavorable HD.

Consolidation radiation after complete remission in Hodgkin's disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need?

  • S. LaskarT. Gupta K. Dinshaw
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2004
TLDR
It is suggested that the addition of consolidation radiation helps improve the EFS and OS in patients achieving a complete remission after six cycles of ABVD chemotherapy, particularly in the younger age group and in patients with B symptoms and bulky and advanced disease.

Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin's disease.

  • O. PressM. Leblanc R. Fisher
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2001
TLDR
It is demonstrated that it is possible to obtain a high failure-free survival rate in a large group of stage IA to IIA patients without performing staging laparotomy and that three cycles of chemotherapy plus STLI provide a superior FFS compared with STLI alone.

Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin's disease who achieve a complete response to chemotherapy.

TLDR
LD-IFRT after an initial complete response to risk-adapted chemotherapy improved EFS, but follow-up remains short; at this time, there is no survival advantage for LD-IF RT.

An update on the Vancouver experience in the management of advanced Hodgkin's disease treated with the MOPP/ABV Hybrid program.

TLDR
This long-term follow-up report supports the initial impression that the MOPP/ABV Hybrid chemotherapy is an effective and well-tolerated program for patients with advanced Hodgkin's disease.

Randomized comparison of ABVD chemotherapy with a strategy that includes radiation therapy in patients with limited-stage Hodgkin's lymphoma: National Cancer Institute of Canada Clinical Trials Group and the Eastern Cooperative Oncology Group.

TLDR
Although 5-year freedom from disease progression was superior in patients receiving radiation therapy, this advantage is offset by deaths due to causes other than progressive Hodgkin's lymphoma or acute treatment-related toxicity.

Transformation in the use of radiation therapy of Hodgkin lymphoma: New concepts and indications lead to modern field design and are assisted by PET imaging and intensity modulated radiation therapy (IMRT)

  • J. Yahalom
  • Medicine
    European journal of haematology. Supplementum
  • 2005
TLDR
Introducing intensity modulated radiotherapy technology (IMRT) – a technology that was originally designed for small tumors treated with very high doses – to the field of lymphoma provides safer and more accurate radiotherapy to selected patients with very bulky residual disease and permits re‐irradiation of relapsed disease.