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Patients with early Hodgkin lymphoma whose PET scan was clear after three cycles of ABVD did almost as well without radiotherapy as with it, with a small extra risk of relapse but no difference in survival, giving them a choice.
UK randomised non-inferiority trial of 602 patients with stage IA or IIA non-bulky Hodgkin lymphoma; those with a negative PET after three cycles of ABVD (420 patients) were randomised to involved-field radiotherapy of 30 Gy or no further treatment.
Three-year progression-free survival was 94.6 percent with radiotherapy against 90.8 percent without, which did not meet the pre-specified non-inferiority margin in the intention-to-treat analysis, while overall survival was the same. Omitting radiotherapy trades a few percentage points of relapse for avoiding late radiation effects.
PET-negative early Hodgkin lymphoma can be treated with chemotherapy alone at a small cost in relapse, an option many younger patients take to avoid radiation to the chest and neck.
Shares Dacarbazine, Vinblastine, Early-stage classical Hodgkin lymphoma (stage I to II), Doxorubicin.
Shares Dacarbazine, Vinblastine, Early-stage classical Hodgkin lymphoma (stage I to II), Doxorubicin.
Shares Dacarbazine, Vinblastine, Doxorubicin, New England Journal of Medicine.
Shares Dacarbazine, Vinblastine, Doxorubicin.
Shares Dacarbazine, Vinblastine, Doxorubicin.
Shares Vinblastine, Doxorubicin.
Shares Early-stage classical Hodgkin lymphoma (stage I to II), New England Journal of Medicine.