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Lymphoma. Hodgkinlymfomen and non-Hodgkin's disease

Information on current developments in both regular and alternative or complementary treatments and resources for lymphoma - non-Hodgkin's lymphoma and Hodgkin's disease at all stages.

Recent articles in left column more or less in alphabetical order classified

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Chemotherapy and radiotherapy: 2x 2x irradiation after chemotherapy for lymphoma - Hodgkin lymphoma shows similar results on disease-free and recurrence rates as 4x irradiation, but obviously with much less chance of serious side effects and later complications such as other cancers. Thus long-term randomized phase III study. Article posted August 15, 2010

August 14, 2010: Source: N Engl J Med. 2010, 363:640-652, 653-662.

Fewer and less intense irradiation of early stage lymphoma after chemotherapy shows similar results on disease-free and overall survival with fewer severe side effects. People with an early form of lymphoma - Hodgkin lymphoma, appear to be standard intensively treated with radiotherapy (EBRT) after chemotherapy with the increased risk later in life that other forms of cancer and severe heart failure. (See also this study from 2003 shows). This shows a long-term randomized phase III study, published in N Engl J Med.

Disease-free survival compared

The researchers studied 1270 patients were randomized into four groups, newly diagnosed with lymphoma - Hodgkin's lymphoma and a favorable prognosis: 2 or 4 cycles of chemo (ABVD) followed by radiotherapy with 30 Gy or 20 Gy (Table 1).

Table 1: Reduced Intensity Treatment in Early Hodgkin's Lymphoma

ABVD doses: 25 mg / m ² ofdoxorubicin, 10 mg / m ² or bleomycin, 6 mg / m ² or vinblastine, and 375 mg / m ² or dacarbazine

The researchers report that patients in all 4 groups resutlaat letien a good record as regards disease-free and overall survival after 5 years. After 5 years, disease-free survival was 93% with 4 cycles of ABVD and 91.1% with two cycles. There were no significant differences in overall survival between 30 Gy and 20 Gy radiation doses.

As expected, patients who had 4 cycles of ABVD had received more treatment-related side effects and acute toxicity than those who had received 2 cycles (grade 3 or 4 toxicities: 51.7% vs 33.2%).

The authors conclude that "patients with lymphoma at an early stage of Hodgkin and a favorable prognosis, treatment with 2 cycles of ABVD followed by irradiation with 20 Gy, is as effective and less toxic than 4 cycles of ABVD followed by radiation with 30 Gy '

But they warn that "given the fact that many of the late, fatal complication of radiation can appear only in the second decade after treatment, our data can not be used to determine the effect of treatment on overall survival measure."

"The next question is whether radiotherapy can be omitted after 2 or 3 cycles of ABVD in patients [positron emission tomography]-negative. We and the [European Organization for Research on Cancer Treatment] perform large clinical trials of this question answer, "said Dr. Engert.

Quote from Medscape comments you read the full report read:

The researchers report thats all 4 regimens Produced similar freedom from treatment failure and overall survival. At 5 years, failure-free survival rates Were 93% with 4 cycles of ABVD and 91.1% with two cycles. Were there no significant differences in freedom from treatment failure or overall survival Between the 30 Gy and 20 Gy radiation doses.

Ash expected, patient who had 4 cycles of ABVD had more adverse events and treatment-related acute toxicity Than Those Who had 2 cycles (grade 3 or 4 toxicity: 51.7% vs 33.2%).

The authors conclude the that "in patient with early-stage Hodgkin's lymphoma and a Favorable prognosis, treatment with 2 cycles of ABVD followed by 20 Gy of Involved-field radiation therapy is as effective as, and less toxic than, 4 cycles of ABVD followed by or 30 Gy Involved-field radiation therapy. "

However, They caution that "Given That many of the late, fatal Complications of radiation therapy do not emerge" Until the second decade after treatment, our data can not speak to the impact of treatment on overall survival. "

"The next question is whethere radiotherapy can-be obliterated after 2 or 3 cycles of ABVD in patient who are [positron emission tomography]-negative. We and the [European Organization for Research on Cancer Treatment] are running large clinical trials to answer this question "Dr. Engert said.