Linfoma de Hodgkin: aspectos práticos da abordagem radioterápica
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linfoma, doença de Hodgkin, radioterapiaResumo
O papel da radioterapia na abordagem do linfoma de Hodgkin (LH) é bem definido. O objetivo deste estudo é apresentar e situar a radioterapia no tratamento atual dessa entidade. O LH pode ser subdividido em grupos favoráveis e desfavoráveis ao tratamento, de acordo com o prognóstico; o primeiro apresenta melhores resultados na terapia combinada (quimioterapia - QT - e radioterapia - RT) quando comparados ao segundo. Neste, usar campos menores de irradiação (a tendência atual para radioterapia) não tem diferença na sobrevida. Em favoráveis no estádio inicial, doses menores de QT e RT são eficazes. Nos estágios III e IV em geral, a adição de RT apenas aumenta o tempo livre de doença, mas não a sobrevida.Downloads
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Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, et al, editores. SEER Cancer Statistics Review, 1975-2008, National Cancer Institute [Internet]. Bethesda, MD: 2010 [acesso em 20 fev. 2011]. Disponível em: http://seer.cancer.gov/csr/1975_2008/.
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Genebra: WHO; 2008.
Specht L, Gray RG, Clarke MJ, Peto R. Influence of more extensive radiotherapy and adjuvant chemotherapy on long-term outcome of early-stage Hodgkin's disease: a meta-analysis of 23 randomized trials involving 3,888 patients. International Hodgkin's Disease Collaborative Group. J Clin Oncol. 1998; 16(3):830-43.
Noordijk EM, Thomas J, Ferme C. First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin's lymphoma (HL). J Clin Oncol. 2005; 23:6505.
Pavlovsky S, Maschio M, Santarelli MT, Muriel FS, Corrado C, Garcia I, et al. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage I–II Hodgkin's disease. J Natl Cancer Inst. 1988; 80(18):1466-73.
Noordijk, EM, Carde P, Dupouy N, Hagenbeek A, Krol ADG, Kluin-Nelemans JC, et al. Combined-modality therapy for clinical stage I or II Hodgkin's lymphoma: long-term results of the European Organization for Research and Treatment of Cancer (EORTC) H7 randomized controlled trials. J Clin Oncol. 2006; 24:3128-35.
Ferme C, Eghbali H, Meerwaldt JH, Rieux C , Bosq J, Berger F, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med. 2007; 357:1916.
Engert A, Schiller P, Josting A, Herrmann R, Koch P, Sieber M, et al. 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. J Clin Oncol. 2003; 21:3601-8.
Campbell BA, Voss N, Pickles T, Morris J, Gascoyne RD, Savage KJ, Connors JM. Involved-nodal radiation therapy as a component of combination therapy for limited-stage hodgkin's lymphoma: a question of field size. J Clin Oncol. 2008; 26(32):5170-4.
Diehl V, Brillant C, Engert A. Reduction of combined modality treatment intensity in early stage Hodgkin's lymphoma: Interim analysis of the HD10 trial of the GHSG (abstract). Blood. 2004; 104:368a.
Diehl, V, Pluetschow, A, Eich, H, et al. Two Cycles of ABVD Followed by Involved Field Radiotherapy with 20 Gray (Gy) Is the New Standard of Care in the Treatment of Patients with Early-Stage Hodgkin Lymphoma: Final Analysis of the Randomized German Hodgkin Study Group (GHSG) HD10. Study Supported by the Deutsche Krebshilfe and in Part by the Competence Network Malignant Lymphoma. Blood 2009; 114:299 (Abstr 716). (Available online at http://ash.confex.com/ash/2009/webprogram/Paper21388.html, accessed April 15, 2010).
Thomas J, Ferme C, Noordijk EM, et al. EORTC lymphoma group; groupe d'études des lymphomes adultes (GELA). Results of the EORTC-GELA H9 randomized trials: The H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin's lymphoma (HL). Haematologica. 2007; 92(S5):27.
National Comprehensive Cancer Network. Practice Guidelines in Oncology. Hodgkin Lymphoma [Internet]. Fort Washington: NCCN: 2008 [acesso em 10 jul. 2010]. Disponível em: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
Nogová L, Reineke T, Eich HT, Josting A, Muller-Hermelink HK, Wingbermuhle K. Extended field radiotherapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin's lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG). Ann Oncol. 2005; 16(10):1683-7.
Nogová L, Reineke T, Brillant C, Sieniawski M, Rudiger T, Josting A, et al. RP, Muller-Hermelink HK, Diehl V, Engert A; German Hodgkin Study Group.Lymphocyte-predominant and classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol. 2008;26(3):434-9.
Haas, RL, Girinsky, T, Aleman, BM, et al. Low-dose involved-field radiotherapy as alternative treatment of nodular lymphocyte predominance Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys. 2009; 74:1199.
Wirth A, Yuen K, Barton M, Roos D, Gogna K , Pratt G, et al. Long-term outcome after radiotherapy alone for lymphocyte-predominant Hodgkin lymphoma: a retrospective multicenter study of the Australasian Radiation Oncology Lymphoma Group. Cancer. 2005; 104:1221.
Loeffler M, Brosteanu O, Hasenclever D, Sextro M, Assouline D, Bartolucci AA, et al. Meta-analysis of chemotherapy versus combined modality treatment trials in Hodgkin's disease. International Database on Hodgkin's Disease Overview Study Group. J Clin Oncol. 1998; 16:818.
Fabian CJ, Mansfield CM, Dahlberg S, Jones SE, Miller TP, Van Slyck E, et al. Low-dose involved field radiation after chemotherapy in advanced Hodgkin disease. A Southwest Oncology Group randomized study. Ann Intern Med. 1994; 120:903.
Yahalom J, Ryu J, Straus DJ, Gaynor JJ, Myers J, Caravelli J, et al. Impact of adjuvant radiation on the patterns and rate of relapse in advanced-stage Hodgkin's disease treated with alternating chemotherapy combinations. J Clin Oncol. 1991; 9:2193.
Longo DL, Russo A, Duffey PL, Hubbard SM, Glatstein E, Hill JB, et al. Treatment of advanced-stage massive mediastinal Hodgkin's disease: the case for combined modality treatment. J Clin Oncol. 1991; 9:227.
Aleman BM, Raemaekers JM, Tomisic R, Baaijens MH, Bortolus R, Lybeert ML, et al. Involved-field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys. 2007; 67:19.
Bartlett NL, Rosenberg SA, Hoppe RT, Hancock SL, Horning SJ. Brief chemotherapy, Stanford V, and adjuvant radiotherapy for bulky or advanced stage Hodgkin's disease: a preliminar report. J Clin Oncol.1995; 13:1080.
Chung HT, Shiao SL, Schechter NR. Hodgkin's lymphoma. In: Hansen EK, Roach III M, editores. Handbook of evidence-based radiation oncology. 2nd ed. New York: Springer; 2010. p.563-592.
Yahalom J, Mauch P. The involved field is back: issues in delineating the radiation field in Hodgkin's disease. Ann Oncol. 2002; 13 Suppl 1:79-83.
Girinsky T, van der Maazen R, Specht L, Aleman B, Poortmans P, Lievens Y, et al. Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol. 2006; 79(3):270-7.
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