Journal
LEUKEMIA & LYMPHOMA
Volume 61, Issue 10, Pages 2442-2447Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428194.2020.1768388
Keywords
Hodgkin lymphoma; radiotherapy; PET (positron emission tomography)
Categories
Funding
- National Institutes of Health/National Cancer Institute/National Clinical Trials Network [CA180888, CA180819, CA180821, CA180820, UG1CA233339, CA180833, CA180818, CA11083, CA04919]
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The role of radiotherapy (RT) in the management of advanced Hodgkin Lymphoma (HL) is inadequately defined in this era of functional imaging with PET scan. SWOG-S0816 treated advanced stage Hodgkin lymphoma patients with ABVD+/- escBEACOPP and no RT. We queried whether RT might have benefited patients in S0816 who would have met the GHSG-HD15 criteria for RT by simulating RT use as per HD15 criteria of PET + residual disease >= 2.5 cm. Receiver-operating-characteristics analyses were performed by varying disease-control rates within radiation fields and size cutoffs for residual disease. Among the 49 PET3+ S0816 patients, RT would have raised the 2-year PFS from 30.6% to 50.2-58.1% using three residual disease cutoffs (1.5, 2.0 and 2.5 cm) and assuming 80 and 90% in-field control rates . Although there may be improvement in PFS as size cutoff point is lowered, consequential toxicities from RT require further definition to assess relative benefits.
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