PMID- 30539763
OWN - NLM
STAT- MEDLINE
DCOM- 20190923
LR  - 20190923
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 129
IP  - 3
DP  - 2018 Dec
TI  - Prognostic factors and patterns of failure in advanced stage Hodgkin lymphoma 
      treated with combined modality therapy.
PG  - 507-512
LID - S0167-8140(18)33348-6 [pii]
LID - 10.1016/j.radonc.2018.06.033 [doi]
AB  - BACKGROUND AND PURPOSE: The role of irradiation to non-bulky and bulky sites of 
      disease in advanced stage Hodgkin lymphoma is controversial. We aimed to review 
      the long-term outcomes of patients treated with combined modality therapy to 
      clarify the role of consolidative radiotherapy. MATERIALS AND METHODS: Patients 
      with stage III or IV Hodgkin lymphoma treated with Stanford V chemotherapy and 
      consolidative radiotherapy to initial sites of disease >/=5 cm were analyzed 
      retrospectively to determine patient outcomes, patterns of failure, and factors 
      associated with treatment failure. RESULTS: A total of 170 patients were 
      analyzed. Overall survival was 91.2%, freedom from progression was 80.6%, and 
      progression-free survival was 78.9% at 10 years. 5 patients (2.9%) had refractory 
      disease and 27 patients (15.9%) relapsed after treatment. Only an International 
      Prognostic Score (IPS) greater than 2 predicted disease progression. 19 out of 27 
      relapses occurred exclusively outside of the radiation treatment field, and 17 
      out of 27 relapses occurred exclusively at original sites of disease. However, 
      only 11 of 170 patients (6.5%) relapsed exclusively at original, non-bulky sites 
      of disease not treated with radiation therapy. The cumulative incidence of local 
      failure at 10 years was 4.6% for unirradiated sites and 2.6% for irradiated 
      sites. CONCLUSION: Patients with advanced stage Hodgkin lymphoma treated with 
      combined modality therapy including consolidative radiotherapy to bulky disease 
      sites had excellent long-term outcomes. Given the low frequency of isolated 
      failures at initial sites, our results suggest that selective radiation therapy 
      to sites at high risk of relapse may be feasible.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Moding, Everett J
AU  - Moding EJ
AD  - Department of Radiation Oncology, Stanford University School of Medicine, 
      Stanford, USA.
FAU - Advani, Ranjana
AU  - Advani R
AD  - Department of Medicine, Stanford University School of Medicine, Stanford, USA.
FAU - Rosenberg, Saul A
AU  - Rosenberg SA
AD  - Department of Radiation Oncology, Stanford University School of Medicine, 
      Stanford, USA; Department of Medicine, Stanford University School of Medicine, 
      Stanford, USA.
FAU - Hoppe, Richard T
AU  - Hoppe RT
AD  - Department of Radiation Oncology, Stanford University School of Medicine, 
      Stanford, USA. Electronic address: rhoppe@stanford.edu.
LA  - eng
PT  - Journal Article
DEP - 20180706
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Combined Modality Therapy
MH  - Female
MH  - Hodgkin Disease/mortality/pathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Retrospective Studies
MH  - Treatment Failure
MH  - Young Adult
OTO - NOTNLM
OT  - Advanced stage
OT  - Combined modality therapy
OT  - Hodgkin lymphoma
OT  - Patterns of failure
OT  - Prognostic factors
OT  - Radiation therapy
OT  - Stanford V
EDAT- 2018/12/13 06:00
MHDA- 2019/09/24 06:00
CRDT- 2018/12/13 06:00
PHST- 2018/04/19 00:00 [received]
PHST- 2018/06/20 00:00 [revised]
PHST- 2018/06/23 00:00 [accepted]
PHST- 2018/12/13 06:00 [entrez]
PHST- 2018/12/13 06:00 [pubmed]
PHST- 2019/09/24 06:00 [medline]
AID - S0167-8140(18)33348-6 [pii]
AID - 10.1016/j.radonc.2018.06.033 [doi]
PST - ppublish
SO  - Radiother Oncol. 2018 Dec;129(3):507-512. doi: 10.1016/j.radonc.2018.06.033. Epub 
      2018 Jul 6.