title: Involved-field radiotherapy for advanced Hodgkin's lymphoma.
abstract: BACKGROUND
  The use of involved-field radiotherapy after chemotherapy for advanced Hodgkin's lymphoma is controversial.
  
  
  METHODS
  We randomly assigned patients with previously untreated stage III or IV Hodgkin's lymphoma who were in complete remission after hybrid chemotherapy with mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPP-ABV) to receive either no further treatment or involved-field radiotherapy. Radiotherapy consisted of 24 Gy to all initially involved nodal areas and 16 to 24 Gy to all initially involved extranodal sites. Patients in partial remission were treated with 30 Gy to nodal areas and 18 to 24 Gy to extranodal sites.
  
  
  RESULTS
  Of 739 patients, 421 had a complete remission; 161 of these patients were assigned to no further treatment, and 172 to involved-field radiotherapy. The median follow-up was 79 months. The five-year event-free survival rate was 84 percent in the group that did not receive radiotherapy and 79 percent in the group that received involved-field radiotherapy (P=0.35). The five-year overall survival rates were 91 and 85 percent, respectively (P=0.07). Among the 250 patients in partial remission after chemotherapy, the five-year event-free and overall survival rates were 79 and 87 percent, respectively.
  
  
  CONCLUSIONS
  Involved-field radiotherapy did not improve the outcome in patients with advanced-stage Hodgkin's lymphoma who had a complete remission after MOPP-ABV chemotherapy. Radiotherapy may benefit patients with a partial response after chemotherapy.
authors.affiliation: Netherlands Cancer Institute, Amsterdam, The Netherlands. b.aleman@nki.nl
authors.forename: Berthe M P
authors.initials: BM
authors.lastname: Aleman
authors.forename: John M M
authors.initials: JM
authors.lastname: Raemaekers
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Bortolus
authors.forename: Mars B
authors.initials: MB
authors.lastname: van 't Veer
authors.forename: Marnix L M
authors.initials: ML
authors.lastname: Lybeert
authors.forename: Jo J
authors.initials: JJ
authors.lastname: Keuning
authors.forename: Patrice
authors.initials: P
authors.lastname: Carde
authors.forename: Théodore
authors.initials: T
authors.lastname: Girinsky
authors.forename: Richard W M
authors.initials: RW
authors.lastname: van der Maazen
authors.forename: Radka
authors.initials: R
authors.lastname: Tomsic
authors.forename: Marjeta
authors.initials: M
authors.lastname: Vovk
authors.forename: Achilles
authors.initials: A
authors.lastname: van Hoof
authors.forename: Geertrui
authors.initials: G
authors.lastname: Demeestere
authors.forename: Pieternella J
authors.initials: PJ
authors.lastname: Lugtenburg
authors.forename: José
authors.initials: J
authors.lastname: Thomas
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schroyens
authors.forename: Koenraad
authors.initials: K
authors.lastname: De Boeck
authors.forename: Johanna W
authors.initials: JW
authors.lastname: Baars
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Kluin-Nelemans
authors.forename: Christian
authors.initials: C
authors.lastname: Carrie
authors.forename: Malek
authors.initials: M
authors.lastname: Aoudjhane
authors.forename: Dominique
authors.initials: D
authors.lastname: Bron
authors.forename: Houchingue
authors.initials: H
authors.lastname: Eghbali
authors.forename: Wilma G J M
authors.initials: WG
authors.lastname: Smit
authors.forename: Jacobus H
authors.initials: JH
authors.lastname: Meerwaldt
authors.forename: Anton
authors.initials: A
authors.lastname: Hagenbeek
authors.forename: Antonella
authors.initials: A
authors.lastname: Pinna
authors.forename: Michel
authors.initials: M
authors.lastname: Henry-Amar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D012074:Remission Induction; D016019:Survival Analysis; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D004317:Doxorubicin; D011241:Prednisone