title: Quality control of involved-field radiotherapy in patients with advanced Hodgkin's lymphoma (EORTC 20884).
abstract: OBJECTIVE
  To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin's lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinblastine (MOPP-ABV) chemotherapy.
  
  
  METHODS
  A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16-24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose <90% of the prescribed dose.
  
  
  RESULTS
  Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. There was no relationship between incidence or site of relapse and major protocol violations.
  
  
  CONCLUSIONS
  In advanced-stage HL patients in complete remission after six to eight cycles of MOPP-ABV, the outcome was not influenced by violation of the radiotherapy protocol.
authors.affiliation: Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands. b.aleman@nki.nl
authors.forename: Berthe M P
authors.initials: BM
authors.lastname: Aleman
authors.forename: Théodore
authors.initials: T
authors.lastname: Girinsky
authors.forename: Richard W M
authors.initials: RW
authors.lastname: van der Maazen
authors.forename: Simon
authors.initials: S
authors.lastname: Strijk
authors.forename: Paul
authors.initials: P
authors.lastname: Meijnders
authors.forename: Roberto
authors.initials: R
authors.lastname: Bortolus
authors.forename: Manouk J J
authors.initials: MJ
authors.lastname: Olofsen-van Acht
authors.forename: Marnix L M
authors.initials: ML
authors.lastname: Lybeert
authors.forename: Yolande
authors.initials: Y
authors.lastname: Lievens
authors.forename: Houchingue
authors.initials: H
authors.lastname: Eghbali
authors.forename: Evert M
authors.initials: EM
authors.lastname: Noordijk
authors.forename: Radka
authors.initials: R
authors.lastname: Tomsic
authors.forename: Jacobus H
authors.initials: JH
authors.lastname: Meerwaldt
authors.forename: Philip M P
authors.initials: PM
authors.lastname: Poortmans
authors.forename: Wilma G J M
authors.initials: WG
authors.lastname: Smit
authors.forename: Antonella
authors.initials: A
authors.lastname: Pinna
authors.forename: Michel
authors.initials: M
authors.lastname: Henry-Amar
authors.forename: John M M
authors.initials: JM
authors.lastname: Raemaekers
mesh_terms: 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; D006689:Hodgkin Disease / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015182:Lymphatic Irradiation / Q000592:standards; D008466:Mechlorethamine / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011786:Quality Control; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D012189:Retrospective Studies; 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