Salvage radiotherapy following chemotherapy failure in Hodgkin's disease--what is its role?
Radiotherapy is rarely used as salvage therapy following chemotherapy failure in Hodgkin's disease. Analysis of our experience identified only 11 cases from over 400 patients treated, and data from other centres are similarly sparse. Three (43%) of 7 patients with relapse confined to nodal sites were salvaged with radiotherapy alone. Actuarial relapse free survival at 5 years was 27% (+/- 12 SE) with survival 45% (+/- 15 SE). These data were then combined with four other detailed series in the literature to delineate the patient and disease characteristics of 60 patients, and better assess the role of salvage radiotherapy. This confirms that radiotherapy has an important role in salvaging a small proportion of cases, who can be spared the risk of more aggressive regimens, such as high dose chemotherapy. Patients with relapse confined to one or two nodal sites, and having a disease free interval greater than 12 months, have the best prospects for salvage. Initial stage IV disease seems to have little bearing, provided relapse is confined to nodal sites.
O'Brien
P C
PC
Radiation Oncology Department, Newcastle Mater Misericordiae Hospital, Waratah, Australia.
Parnis
F X
FX
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D016879:Salvage Therapy; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome