Radiation therapy after stem-cell transplantation is safe and effective for relapsed- or refractory Hodgkin lymphoma

This study assessed whether patients with relapsed- or refractory Hodgkin Lymphoma should be treated with radiation therapy. The authors concluded that radiation therapy was safe and prevented the return of the disease in certain patients.

Hodgkin lymphoma is a cancer of the lymph system. It is a curable disease in many patients. In 25% – 30% of advanced-stage patients, however, the disease either relapses or does not respond to treatment (refractory disease). The standard treatment for relapsed- or refractory Hodgkin Lymphoma starts with a second course of chemotherapy. This is followed by high-dose chemotherapy and stem-cell transplantation. Even with these treatments, 40-50% of patients experience disease-progression within 5 years. 

Hodgkin lymphoma often relapses at sites where cancer previously occurred. It is possible that radiation to these sites may prevent disease-progression.

The researchers examined the records of 189 Hodgkin-lymphoma patients. 73% had relapsed disease and 27% had refractory disease. All patients were treated with both high-dose chemotherapy and stem-cell transplantation. 11.6% were also treated with radiation therapy. 

Four-year overall survival rates (time from treatment until death from any cause) were between 67% and 82%. Radiation therapy significantly reduced the return of disease in certain patients. Radiation was associated with a local-control rate of 81% in patients with refractory disease. The disease-control rate was 49% without radiation. Only one patient had severe side-effects following treatment. This patient had low levels of white blood cells, red blood cells and platelets.

The authors concluded that radiation therapy was safe and improved cancer outcomes in certain relapsed- or refractory Hodgkin-lymphoma patients. 

This study only examined a small number of patients. The results need to be confirmed by other prospective studies.

Discuss with your doctor whether or not radiation may be right for you.