ACR Appropriateness Criteria on Hodgkin's lymphoma: favorable prognosis stage I and II.
The treatment for favorable-prognosis stage I and II Hodgkin's lymphoma has evolved over the past several years. Studies have attempted to reduce long-term treatment-related side effects, such as second malignancies and cardiac toxicity, through reduced chemotherapy or reduced radiotherapy. Randomized trials have compared radiation therapy alone with combined-modality therapy (chemotherapy followed by involved-field radiotherapy). Recent and ongoing trials have evaluated the optimal regimen and number of cycles of chemotherapy and the optimal radiotherapy dose and field size as part of combined-modality therapy, as well as the elimination of radiation therapy. Combined-modality therapy represents the current standard of care for most patients with favorable-prognosis early-stage Hodgkin's lymphoma. Chemotherapy alone could also be an option for selected patients who are at low risk for relapse and high risk for late effects from radiotherapy. This article reviews recent and ongoing studies on treatment for favorable-prognosis early stage Hodgkin's lymphoma. Representative clinical cases are presented, with treatment recommendations from an expert panel of radiation oncologists and medical oncologists.
Das
Prajnan
P
The Universityof Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX 77030, USA. prajdas@mdanderson.org
Ng
Andrea
A
Constine
Louis S
LS
Hodgson
David C
DC
Mendenhall
Nancy P
NP
Morris
David Eric
DE
Yunes
Michael J
MJ
Chauvenet
Allen R
AR
Hudson
Melissa M
MM
Winter
Jane N
JN
D002986:Clinical Trials as Topic; D003695:Delivery of Health Care / Q000592:standards*; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011871:Radiology / Q000592:standards*; D014481:United States