Hodgkin's lymphoma therapy: past, present, and future.
BACKGROUND
The treatment of Hodgkin's lymphoma (HL) with the use of radiotherapy and systemic chemotherapy has been one of the success stories of modern oncology. HL therapy has been the paradigm for the systematic evaluation of different curative modalities, resulting in cure for the majority of patients. The current focus is on designing initial therapeutic strategies that retain efficacy and minimize long-term toxicity. Appropriate use of pathologic, clinical, biologic and radiologic prognostic factors in identification of aggressive HL is paramount in designing a successful therapeutic strategy.


METHODS
This review addresses the current and future use of prognostic tools, including PET scanning and other biomarkers, in identifying patients with aggressive HL, with reference to publications from the last two decades. The current standard approaches with the use of combined modality therapy and systemic chemotherapy as well as the promising role of future response-adapted strategies is reviewed.


RESULTS
The reader will obtain a comprehensive review of risk assessment strategies as well as current and investigational therapeutic approaches in the management of HL.


CONCLUSIONS
In HL, appropriate utilization of risk assessment strategies is required to maximize therapeutic outcomes while minimizing toxicity, especially long-term toxicity. Response-adapted therapy utilizing PET has the potential to profoundly improve the therapeutic landscape in HL.
Department of Medicine, Roger Williams Medical Center, Providence Rhode Island 02908, USA.
Bharti
B
Rathore
Marshall E
ME
Kadin
D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis
D000970:Antineoplastic Agents