PMID- 32622782
OWN - NLM
STAT- MEDLINE
DCOM- 20210414
LR  - 20210414
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 150
DP  - 2020 Sep
TI  - Involved node radiation therapy in the combined modality treatment for 
      early-stage Hodgkin lymphoma: Analysis of relapse location and long-term outcome.
PG  - 236-244
LID - S0167-8140(20)30382-0 [pii]
LID - 10.1016/j.radonc.2020.06.046 [doi]
AB  - BACKGROUND AND PURPOSE: Involved node radiation therapy (INRT) in the combined 
      modality treatment for early-stage Hodgkin lymphoma (ESHL) has reduced the 
      irradiated volume dramatically. Limiting the irradiated volume further based on 
      initial disease bulk, 18F-fluoro-deoxy-glucose (FDG)-avidity, or residual 
      computed tomography (CT) abnormality after chemotherapy seems attractive. In a 
      cohort of patients treated with INRT a meticulous pattern-of-relapse analysis was 
      performed to examine these options. MATERIAL AND METHODS: Patients treated for 
      ESHL in our institution from 2005 to 2014 who achieved complete remission with 
      chemotherapy were included. Patient characteristics, treatment details and 
      clinical outcome were registered. For relapsed patients, rigid co-registration of 
      the positron emission tomography/computed tomography-scans from the time of 
      diagnosis and at relapse was done to visually assess the relapse location 
      relative to initial involvement and, if irradiated, the irradiated volume. Size 
      and maximum Standardized Uptake Value of the initial node(s) with later relapse, 
      and residual CT abnormalities after chemotherapy in those locations were 
      measured. RESULTS: We included 182 patients. Twelve (6.6%) patients relapsed, 
      five in previously involved nodes (two irradiated, three not irradiated). 
      Relapses did not occur preferentially in initially bulky disease, in lymph 
      node(s) with the highest FDG-uptake, or in residual CT abnormalities after 
      chemotherapy. CONCLUSIONS: Modern treatment with brief chemotherapy and limited 
      radiotherapy provides excellent long-term disease control in ESHL. Neither bulk, 
      high FDG-uptake, nor residual CT abnormality after chemotherapy could predict 
      initially involved lymph nodes with a high risk of relapse.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Nielsen, Karin
AU  - Nielsen K
AD  - Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark. Electronic 
      address: karin.nielsen.04@regionh.dk.
FAU - Maraldo, Maja Vestmoe
AU  - Maraldo MV
AD  - Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
FAU - Berthelsen, Anne Kiil
AU  - Berthelsen AK
AD  - Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark; Dept. of 
      Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of 
      Copenhagen, Denmark.
FAU - Loft, Annika
AU  - Loft A
AD  - Dept. of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, 
      University of Copenhagen, Denmark.
FAU - de Nully Brown, Peter
AU  - de Nully Brown P
AD  - Dept. of Haematology, Rigshospitalet, University of Copenhagen, Denmark.
FAU - Vogelius, Ivan Richter
AU  - Vogelius IR
AD  - Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
FAU - Petersen, Peter Meidahl
AU  - Petersen PM
AD  - Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
FAU - Specht, Lena
AU  - Specht L
AD  - Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200703
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Combined Modality Therapy
MH  - Fluorodeoxyglucose F18
MH  - *Hodgkin Disease/diagnostic imaging/radiotherapy
MH  - Humans
MH  - Neoplasm Recurrence, Local
MH  - Positron Emission Tomography Computed Tomography
MH  - Positron-Emission Tomography
MH  - Radiotherapy Dosage
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Hodgkin lymphoma
OT  - Image co-registration
OT  - Involved node radiation therapy
OT  - Relapse location
EDAT- 2020/07/06 06:00
MHDA- 2021/04/15 06:00
CRDT- 2020/07/06 06:00
PHST- 2020/05/12 00:00 [received]
PHST- 2020/06/26 00:00 [revised]
PHST- 2020/06/26 00:00 [accepted]
PHST- 2020/07/06 06:00 [pubmed]
PHST- 2021/04/15 06:00 [medline]
PHST- 2020/07/06 06:00 [entrez]
AID - S0167-8140(20)30382-0 [pii]
AID - 10.1016/j.radonc.2020.06.046 [doi]
PST - ppublish
SO  - Radiother Oncol. 2020 Sep;150:236-244. doi: 10.1016/j.radonc.2020.06.046. Epub 
      2020 Jul 3.