Comparing long-term toxicity and efficacy of combined modality treatment including extended- or involved-field radiotherapy in early-stage Hodgkin's lymphoma
2012; Elsevier BV; Volume: 23; Issue: 11 Linguagem: Inglês
10.1093/annonc/mds110
ISSN1569-8041
AutoresStephanie Sasse, Beate Klimm, Helen Görgen, Michael Fuchs, A. Heyden-Honerkamp, Andreas Lohri, Olaf Koch, Mathias Wilhelm, Guido Trenn, Jürgen Finke, R.-P. Müller, Volker Diehl, Hans Theodor Eich, Peter Borchmann, Andreas Engert,
Tópico(s)Breast Cancer Treatment Studies
ResumoBackgroundTo evaluate long-term toxicity and efficacy of a combined modality strategy including extended-field radiotherapy (EF-RT) or involved-field radiotherapy (IF-RT), the German Hodgkin Study Group carried out a follow-up analysis in patients with early unfavorable Hodgkin's lymphoma (HL).Patients and methodsOne thousand two hundred and four patients were randomized to four cycles of chemotherapy followed by either 30 Gy EF- or 30 Gy IF-RT (HD8 trial); 532 patients in each treatment arm were eligible.ResultsAt 10 years, no arm differences were revealed with respect to freedom from treatment failure (FFTF) (79.8% versus 79.7%), progression-free survival (79.8% versus 80.0%), and overall survival (86.4% versus 87.3%). Non-inferiority of IF-RT was demonstrated for the primary end point FFTF (95% confidence interval for hazard ratio 0.72–1.25). Elderly patients had a poorer outcome when treated with EF-RT. So far, 15.0% of patients in arm A and 12.2% in arm B died, mostly due to secondary malignancies (5.3% versus 3.4%) or HL (3.2% versus 3.4%). After EF-RT, there were more secondary malignancies overall (58 versus 45), especially acute myeloid leukemias (11 versus 4).ConclusionRadiotherapy intensity reduction to IF-RT does not result in poorer long-term outcome but is associated with less acute toxicity and might be associated with less secondary malignancies.
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