Outcomes for Hodgkin lymphoma patients treated with combined modality treatment

This study looked at the long term outcomes for patients with Hodgkin lymphoma who were treated with radiation therapy. The study concluded that patients treated with radiation therapy had better outcomes compared to patients not treated with radiation therapy. 

Patients with Hodgkin lymphoma (HL) generally have good outcomes. Recent treatment strategies focus on reducing intensity to reduce the risk of later complications. ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine) is the standard treatment for HL.

After ABVD treatment, many patients will achieve a complete response (no detectable cancer on PET-CT scan). After achieving a complete response, some patients will receive radiation therapy as well. It is unclear if additional radiation therapy increases the risk of future complications. 

The medical records of 90 patients were reviewed. 44 patients received chemotherapy alone. 46 patients received combined modality treatment (CMT), both chemotherapy and radiation therapy. Most patients received ABVD chemotherapy. The average length of follow up was 50 months.

The 5-year progression free survival rate (time from treatment to disease progression) for all patients was 77%. The 5-year progression free survival rate was 88% for patients treated with CMT. The 5-year progression free survival rate was 65% for chemotherapy alone. The difference was statistically significant.

The 10-year overall survival rate (time from treatment to death from any cause) was 92% for people treated with CMT. The 10-year overall survival rate for patients treated with chemotherapy alone was 60%.

Secondary cancers developed in 4 patients treated with chemotherapy alone and 5 patients treated with CMT. Of the secondary cancers in patients treated with CMT, 4 were inside the radiation field.

The study concluded that Hodgkin lymphoma patients who were treated with combined modality treatment had better progression free survival rates compared to patients treated with chemotherapy alone. 

Patients who were treated with combined modality treatment were more likely to be younger and have a lower international prognostic score. This may have impacted the outcomes between the two groups.