PMID- 25841720
OWN - NLM
STAT- MEDLINE
DCOM- 20160203
LR  - 20220129
IS  - 2304-3873 (Electronic)
IS  - 2304-3865 (Linking)
VI  - 4
IP  - 1
DP  - 2015 Mar
TI  - Risk- and response-adapted strategies for the management of Hodgkin lymphoma.
PG  - 13
LID - 10.3978/j.issn.2304-3865.2015.03.04 [doi]
AB  - Therapy for Hodgkin lymphoma (HL) is associated with excellent long-term survival 
      rates, of 80% of more. Extended follow up has described late treatment-related 
      toxicities, principally secondary malignancies, cardiovascular disease and 
      infertility. Given the young age of many patients, there is a desire to offer a 
      more personalised approach, correlated to individual tumour biology that enables 
      treatment de-escalation in low risk patients to reduce toxicity, and treatment 
      intensification in high risk patients to reduce treatment failure. Contemporary 
      therapeutic strategies have involved risk assessment based on staging and 
      clinical factors. The use of functional imaging with 18F-fluorodeoxyglucose 
      positron emission tomography (18F-FDG-PET) as a predictive tool to identify early 
      non-responders has been well validated and outperforms the risk stratifying 
      International Prognostic Score (IPS). HL has particularly high FDG-avidity 
      (97-100%), with FDG-PET scanning reflecting metabolic activity and acting as a 
      surrogate biomarker for chemosensitivity. International consensus on the methods 
      of reporting and interpreting FDG-PET scans has enabled their use to be 
      standardised and reproducible. Given that primary therapy fails for 15-20% of 
      patients, the use of combined FDG-PET and computerised tomography (FDG-PET/CT) to 
      provide a response-adapted strategy to guide management is under investigation in 
      numerous prospective clinical trials. They aim to determine whether early 
      response scanning can be used to directly modulate subsequent therapy, through 
      intensifying or abbreviating chemotherapy regimens and/or omitting radiotherapy. 
      Integrated multi-modality imaging and advanced conformal planning techniques have 
      led to the emergence of radiotherapy strategies such as involved-node radiation 
      (INRT) that aim to optimise treatment volumes and maintain efficacy whilst 
      lowering toxicity. Study groups have incorporated these modalities in trial 
      designs to assess whether a PET-directed, individualised approach can become the 
      new standard of care.
FAU - Remer, Marcus
AU  - Remer M
AD  - Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, University 
      of Southampton, Southampton General Hospital, Hampshire SO16 6YD, UK.
FAU - Johnson, Peter W M
AU  - Johnson PW
AD  - Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, University 
      of Southampton, Southampton General Hospital, Hampshire SO16 6YD, UK. 
      johnsonp@soton.ac.uk.
LA  - eng
GR  - 9619/CRUK_/Cancer Research UK/United Kingdom
PT  - Journal Article
PT  - Review
PL  - China
TA  - Chin Clin Oncol
JT  - Chinese clinical oncology
JID - 101608375
RN  - 0 (Radiopharmaceuticals)
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Age Factors
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - *Chemoradiotherapy/adverse effects/mortality
MH  - Fluorodeoxyglucose F18
MH  - Hodgkin Disease/*diagnosis/mortality/*therapy
MH  - Humans
MH  - *Multimodal Imaging/methods
MH  - Neoplasm Staging
MH  - Patient Selection
MH  - Positron-Emission Tomography
MH  - Predictive Value of Tests
MH  - Radiopharmaceuticals
MH  - Radiotherapy Dosage
MH  - Risk Assessment
MH  - Risk Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
OTO - NOTNLM
OT  - 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)
OT  - BEACOPP
OT  - Combination of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD)
OT  - Hodgkin lymphoma (HL)
OT  - involved-node radiation (INRT)
OT  - risk-adapted
EDAT- 2015/04/07 06:00
MHDA- 2016/02/04 06:00
CRDT- 2015/04/06 06:00
PHST- 2015/03/18 00:00 [received]
PHST- 2015/03/19 00:00 [accepted]
PHST- 2015/04/06 06:00 [entrez]
PHST- 2015/04/07 06:00 [pubmed]
PHST- 2016/02/04 06:00 [medline]
AID - 10.3978/j.issn.2304-3865.2015.03.04 [doi]
PST - ppublish
SO  - Chin Clin Oncol. 2015 Mar;4(1):13. doi: 10.3978/j.issn.2304-3865.2015.03.04.