title: The addition of radiotherapy to chemotherapy does not improve outcome of early stage Hodgkin's lymphoma patients: a retrospective long-term follow-up analysis of a regional Italian experience.
abstract: We retrospectively reviewed 139 stage I-II HL patients who were diagnosed and followed up in an Italian northern region (Liguria) from 1995 to 2007, and who received either chemotherapy (CT) alone (mainly doxorubicin, bleomycin, vinblastine, and dacarbazine; ABVD) or a combined modality treatment (chemotherapy + radiotherapy, CT + RT). The two therapeutic groups were comparable for clinical and histologic features. Complete remission rate after CT + RT was higher than what was achieved with CT alone (96% vs. 84%, respectively, p = 0.03). Relapse rate (12%) was the same in both groups and disease-free survival curves were comparable (82% and 83%, p = 0.47). The overall survival of the two therapeutic groups is comparable. No second tumors have been reported among patients receiving chemotherapy alone, whereas a second neoplasia has been diagnosed in four patients (in two cases possibly radiotherapy related) in the CT + RT group (5%, p = 0.09) In conclusion, our retrospective study shows that CT + limited RT is an effective and well-tolerated option for early stage Hodgkin's lymphoma, even if the use of RT is associated with a certain risk of developing a second tumor. However, four to six courses of ABVD can lead to similar, optimal, long-term disease control without exposing patients to the risk of a second neoplasia.
authors.affiliation: Department of Haematology and Oncology, University of Genova, San Martino Hospital, Viale Benedetto XV, N 6, Genova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Olcese
authors.forename: Marino
authors.initials: M
authors.lastname: Clavio
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rossi
authors.forename: Mauro
authors.initials: M
authors.lastname: Spriano
authors.forename: Filippo
authors.initials: F
authors.lastname: Ballerini
authors.forename: Letizia
authors.initials: L
authors.lastname: Canepa
authors.forename: Ivana
authors.initials: I
authors.lastname: Pierri
authors.forename: Sara
authors.initials: S
authors.lastname: Aquino
authors.forename: Riccardo
authors.initials: R
authors.lastname: Varaldo
authors.forename: Annunziata
authors.initials: A
authors.lastname: Manna
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Secondo
authors.forename: Omar
authors.initials: O
authors.lastname: Racchi
authors.forename: Enrico
authors.initials: E
authors.lastname: Balleari
authors.forename: Giulio Fraternali
authors.initials: GF
authors.lastname: Orcioni
authors.forename: Angelo Michele
authors.initials: AM
authors.lastname: Carella
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ghio
authors.forename: Marco
authors.initials: M
authors.lastname: Gobbi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy*; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents