Hodgkin's lymphoma: practical aspects of radiation therapy approach

Authors

  • Gustavo Nader Marta Centro de Oncologia do Hospital Sírio-Libanês
  • Carlos Eduardo Cintra Vita Abreu Centro de Oncologia do Hospital Sírio-Libanês

Keywords:

lymphoma, Hodgkin's disease, radiotherapy.

Abstract

ABSTRACT The role played by radiotherapy in Hodgkin's Lymphoma (HL) is well defined. This study discusses its importance in the current treatment of this disease. HL can be subdivided into groups favorable and unfavorable to treatment, according to the prognosis. Combined therapy (chemotherapy - CT - and radiotherapy - RT) presents better results for the first group. In the second group, using narrower fields of irradiation (the current approach) implies in no difference in survival time rates. As for those favorable to treatment in initial stages of disease, smaller doses of CT and RT are efficacious. For stages III and IV in general, the use of combined therapy only increases the free-of-disease time span, but not the overall survival time.

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Author Biographies

Gustavo Nader Marta, Centro de Oncologia do Hospital Sírio-Libanês

Médico residente em Radioterapia Centro de Oncologia do Hospital Sírio-Libanês

Carlos Eduardo Cintra Vita Abreu, Centro de Oncologia do Hospital Sírio-Libanês

Médico Centro de Oncologia do Hospital Sírio-Libanês

References

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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Published

2012-04-03

How to Cite

1.
Marta GN, Abreu CECV. Hodgkin’s lymphoma: practical aspects of radiation therapy approach. Rev. Fac. Ciênc. Méd. Sorocaba [Internet]. 2012Apr.3 [cited 2024May22];14(1):1-4. Available from: https://revistas.pucsp.br/index.php/RFCMS/article/view/5358

Issue

Vol. 14 No. 1 (2012)

Section

Update

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