Evaluating intensive first-line treatment for patients with advanced Hodgkin’s lymphoma

This study evaluated the long-term outcomes of patients with advanced Hodgkin’s lymphoma (HL) who received intensive first-line treatment. This study concluded that intensive first-line treatment with or without radiotherapy led to better long-term outcomes in these patients.

For patients with advanced HL, high-dose BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) chemotherapy is recommended. This treatment is effective for many patients. However, it is associated with side effects and long-term complications, such as secondary cancer.

Consolidation radiotherapy is used after initial treatment to get rid of any remaining cancer cells. Radiotherapy after high-dose BEACOPP may improve long-term outcomes for patients with advanced HL. The effectiveness of these treatments compared to conventional ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy remains under investigation.

This study involved two patient populations with advanced HL. 1282 patients (Group A) received intensive chemotherapy only. 1670 patients (Group B) received intensive chemotherapy with or without radiotherapy. Chemotherapy regimens included BEACOPP or ABVD-based treatment. Patients were followed-up for an average of 97 – 141 months.

In Group A, 15-year progression-free survival (patients still alive 15 years later without tumor growth or spread) was significantly higher with high-dose BEACOPP compared to ABVD (74% vs. 57%). High-dose BEACOPP was significantly associated with a 47% lower risk of disease progression compared to ABVD. 15-year overall survival (patients still alive 15 years later) was also significantly higher with high-dose BEACOPP compared to ABVD (80.9% vs. 72.3%). High-dose BEACOPP was significantly associated with a 32% lower mortality risk.

In Group B, 10-year progression-free survival was lower in patients who did not receive radiotherapy compared to those who did (82.2% vs. 86.8%). Not receiving radiotherapy was associated with a 34% higher risk of disease progression.

At follow-up, 10% of patients in Group A developed secondary cancer compared to 6.4-9.7% in Group B.

This study concluded that intensive first-line treatment with or without radiotherapy improved long-term survival in patients with advanced HL.

This study looked back in time to analyze data. Information collected in this way is not always complete.