Radiation therapy in modern Hodgkin lymphoma treatment

This study reviewed the effectiveness of radiation therapy in treating patients with Hodgkin lymphoma. The study concluded that radiation therapy is continuing to evolve, and it can be successfully used to treat early or advanced Hodgkin lymphoma.

Hodgkin lymphoma (HL) is generally considered a curable disease. Current treatment for early stage HL is combined modality therapy (CMT). CMT includes both chemotherapy and radiation therapy (RT). Treatment for advanced stage HL is more specific to the disease conditions. It can include higher intensity chemotherapy and radiation therapy to larger areas. As chemotherapy regimens are becoming more effective, the role of radiation therapy has changed.

Some experts question whether radiation therapy should still be included in early stage HL treatment. Further research is needed on the effects of reducing radiation therapy in HL treatment.

This review examined the use of RT in HL treatment.

Early stage HL

A large analysis of many studies found that RT is beneficial to patients with early stage HL. The odds of 5-year overall survival (OS; time from treatment until death from any cause) was 60% better for patients who received RT compared to those who did not.

Another large analysis found similar results. The 5-year OS for patients who received RT was 87%. This was compared to 76% for patients who were not treated with RT after chemotherapy.

Advanced stage HL

The use of RT is recommended for advanced stage patients with bulky disease. It is also recommended for patients who do not achieve a complete response (no sign of active disease) after first-line chemotherapy. Chemotherapy intensity, however, can determine the effectiveness of RT. One study suggested that RT is not needed if patients achieve a complete response after BEACOPP chemotherapy (instead of ABVD).

Late Side Effects

RT can be associated with side effects long after treatment. Modern RT methods involve lower doses to smaller areas. This may significantly reduce these effects.

The author concluded that radiation therapy can be useful in patients with early stage HL and those with bulky disease or advanced HL who do not achieve complete response to other treatments.