Involved-Field Radiotherapy prevents recurrences in the early stages of Hodgkin's lymphoma in PET-negative patients after ABVD Chemotherapy Relapse Analysis of GHSG Phase III HD16 Trial

Purpose. Prospective analysis of the efficacy of the original protocol SPbHL-05 was performed.Patients and Methods. Sixty patients with Hodgkin's lymphoma (HL) aged less than 18 years old were treated in accordance with SPbHL-05 from January 2000, to July 2009. In induction chemotherapy we used VBVP and ABVD schedules followed by involved-field radiotherapy. Fourteen patients (23,3%) with 0–2 adverse factors (the favourable group) received two cycles of chemotherapy (VBVP), 25 children (41,7%) with 3-4 unfavorable signs (the intermediate group) received two cycles of VBVP alternating with two cycles of ABVD, 21 patient (35%) who had 5 or more adverse prognostic factors (the unfavourable group) received three cycles of VBVP alternating with three cycles of ABVD.Results. With a median follow-up of 68 months, overall survival (OS) at 5 years is 91.3%, event-free survival (EFS) is 82.8%. OS in the favourable and intermediate risk group were 100%, EFS were 92,9% and 90,7%, respectively, OS and EFS in unfavourable risk group—77,1% and 55,6%, respectively.Conclusion. The identification of prognostic risk factors and using medicines with less prominent side effects would be of major importance in the development of new strategies of treatment for childhood HL.

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Low-Dose Involved-Field Radiotherapy in Relapsed Low-Grade Non-Hodgkin's Lymphoma in Elderly Patients (Mansoura University Experience)

Journal of Cancer Therapy ◽

10.4236/jct.2014.56057 ◽

2014 ◽

Vol 05 (06) ◽

pp. 500-505

Author(s):

Hend Ahmed El-Hadaad ◽

Hanan Ahmed Wahba ◽

Ibrahim Awad

Keyword(s):

Elderly Patients ◽

Hodgkin’S Lymphoma ◽

Low Dose ◽

Hodgkin's Lymphoma ◽

Low Grade ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Involved Field ◽

University Experience ◽

Involved Field Radiotherapy

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Standard CHOP-21 as First Line Treatment for Elderly Patients with Hodgkin’s Lymphoma.

Blood ◽

10.1182/blood.v108.11.4675.4675 ◽

2006 ◽

Vol 108 (11) ◽

pp. 4675-4675

Author(s):

Arne Kolstad ◽

Harald Holte ◽

Ole Nome

Keyword(s):

Elderly Patients ◽

Hodgkin’S Lymphoma ◽

Stage I ◽

Hodgkin's Lymphoma ◽

Advanced Stage ◽

Line Treatment ◽

First Line ◽

Involved Field ◽

Involved Field Radiotherapy ◽

First Line Treatment

Abstract Background: Outcome for elderly patients with Hodgkin’s lymphoma is not as good as for younger patients, partly due to inferior capability to tolerate appropriate chemotherapy. There is no consensus on standard treatment. In 2000 we introduced CHOP-21 as standard chemotherapy for elderly Hodgkin’s lymphoma patients at our institution with the aim to improve treatment results. CHOP-21 is known to be well tolerated in older patients with non-Hodgkin’s lymphoma and contains active drugs for Hodgkin’s disease. Patients and methods: Twenty-nine consequtive patients admitted to our institution from 2000–2004, 60 years and older with Hodgkin’s lymphoma were included in this retrospective survey. Stage I/IIA patients received 2–4 cycles of CHOP-21 followed by 30–35 Gy involved field radiotherapy. Stage IIB-IV patients were treated with 6–8 cycles of CHOP-21. Selected cases received 30–35 Gy involved field radiotherapy against residual tumors. Results: The median age was 71 years (range 60–91). Sixty-two percent presented in stage IIB-IV and 38% in stage I-IIA. Forty-five percent of the early stage patients had bulky disease and/or elevated SR. For the advanced stage patients IPS score of 2–3 was the most common category (72%). B-symptoms occurred in 52% of the total population. Nodular sclerosis was the most frequent histology subgroup (38%), followed by mixed cellularity (17%). Fifty-five percent had co-morbidity prior to treatment, cardiac conditions were most common. Two cases of treatment-related deaths were seen (7%). The most common toxicity during therapy was febrile neutropenia (31%). Treatment modifications were necessary in 38% of cases. The complete response rate after CHOP +/− radiotherapy was as high as 93%. Median follow-up for the whole population is now three years. Five patients have relapsed, and four have died from Hodgkin’s lymphoma. Total overall survival (OS) at three year was 80%, and better for the stage I-IIA subgroup (90% versus 60%). Total Hodgkin-specific survival (HSS) at three years was 73%, and 80% versus 60% for early and advanced stages, respectively. No relapses have occurred after 2 years. Outcome with CHOP +/− radiotherapy for Hodgkin’s lymphoma patients 60 years and older Response 29 pts (%) NE = not evaluable, patients died after one cycle of CHOP. CR 27 (93) PR 1 (3) ORR 28 (97) NE 1 (3) Relapsed 5 (18) Cause of death Hodgkin’s lymphoma 4 (14) Toxicity 2 (7) Other 1 (3) Conclusion: The data shows that CHOP-21 is a well tolerated and highly effective first line treatment for elderly patients with Hodgkin’s lymphoma. Of particular interest were the findings that advanced stage patients did so well and that no relapses have been seen after two years.

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