• N. Engl. J. Med. · Jun 2003

    Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial

    Involved-field radiotherapy for advanced Hodgkin's lymphoma.

    • Berthe M P Aleman, John M M Raemaekers, Umberto Tirelli, Roberto Bortolus, Mars B van 't Veer, Marnix L M Lybeert, Jo J Keuning, Patrice Carde, Théodore Girinsky, Richard W M van der Maazen, Radka Tomsic, Marjeta Vovk, Achilles van Hoof, Geertrui Demeestere, Pieternella J Lugtenburg, José Thomas, Wilfried Schroyens, Koenraad De Boeck, Johanna W Baars, Johanna C Kluin-Nelemans, Christian Carrie, Malek Aoudjhane, Dominique Bron, Houchingue Eghbali, Wilma G J M Smit, Jacobus H Meerwaldt, Anton Hagenbeek, Antonella Pinna, Michel Henry-Amar, and European Organization for Research and Treatment of Cancer Lymphoma Group.
    • Netherlands Cancer Institute, Amsterdam, The Netherlands. b.aleman@nki.nl
    • N. Engl. J. Med. 2003 Jun 12; 348 (24): 2396-406.

    BackgroundThe use of involved-field radiotherapy after chemotherapy for advanced Hodgkin's lymphoma is controversial.MethodsWe randomly assigned patients with previously untreated stage III or IV Hodgkin's lymphoma who were in complete remission after hybrid chemotherapy with mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPP-ABV) to receive either no further treatment or involved-field radiotherapy. Radiotherapy consisted of 24 Gy to all initially involved nodal areas and 16 to 24 Gy to all initially involved extranodal sites. Patients in partial remission were treated with 30 Gy to nodal areas and 18 to 24 Gy to extranodal sites.ResultsOf 739 patients, 421 had a complete remission; 161 of these patients were assigned to no further treatment, and 172 to involved-field radiotherapy. The median follow-up was 79 months. The five-year event-free survival rate was 84 percent in the group that did not receive radiotherapy and 79 percent in the group that received involved-field radiotherapy (P=0.35). The five-year overall survival rates were 91 and 85 percent, respectively (P=0.07). Among the 250 patients in partial remission after chemotherapy, the five-year event-free and overall survival rates were 79 and 87 percent, respectively.ConclusionsInvolved-field radiotherapy did not improve the outcome in patients with advanced-stage Hodgkin's lymphoma who had a complete remission after MOPP-ABV chemotherapy. Radiotherapy may benefit patients with a partial response after chemotherapy.Copyright 2003 Massachusetts Medical Society

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