In a nutshell
The current study examined the use of involved node radiation therapy with different delivery techniques in patients with early-stage Hodgkin lymphoma. The study suggests that radiation to a smaller area is safe and effective in these patients.
Some background
The main treatment options for Hodgkin lymphoma are chemotherapy combined with radiation therapy. Complications from these treatments can affect patient quality of life. Both therapies can also cause complications many years after treatment ends. Large doses of radiation, for example, can increase the risk of second cancers and cardiovascular disease.
To decrease the risk of late complications, radiation should be used at the minimum amount necessary. Involved node radiation therapy can decrease the area affected. This can be delivered in different ways. Intensity-modulated radiation therapy (IMRT) uses a computer to pinpoint the tumor in order to deliver radiation to a precise area. Deep inspiration breath hold (DIBH) radiation is delivered while the patient is holding their breath. This moves the heart and lungs away from the chest wall, minimizing the amount of radiation they receive. It is not clear if these techniques are safe and effective in Hodgkin lymphoma.
Methods & findings
The current study examined the use of IMRT and DIBH in patients with early-stage Hodgkin lymphoma. 50 patients were included in this analysis. 64% were treated with IMRT and 36% were treated with DIBH. 92% were also treated with 3 to 6 cycles of ABVD chemotherapy (adriamycin, bleomycin, vinblastine, and dacarbazine). Average total radiation doses were 40 Gy for the IMRT group and 30.6 Gy for the DIBH group. The IMRT group was followed for an average of 59.9 months. The DIBH group was followed for an average of 36.7 months.
The 5-year overall survival (time from treatment until death from any cause) rate for the IMRT group was 95%. 91% of IMRT patients were cancer progression free at 5 years.
The 3-year overall survival for the DIBH group 93%. 94% were progression free at 3 years.
The majority of early side effects were mild. They included difficulty swallowing, lung inflammation, and skin inflammation. No late (after 6 months) cardiovascular effects were noted. 14% of patients experienced thyroid problems.
The bottom line
This study concluded that radiation, delivered as either IMRT or DIBH, was safe and effective in patients with early-stage Hodgkin lymphoma.
The fine print
Long-term effects can occur many years after treatment. This study does not address effects seen beyond 3 to 5 years.
Published By :
International journal of radiation oncology, biology, physics
Date :
May 01, 2011
