title: Involved node radiation therapy: an effective alternative in early-stage hodgkin lymphoma.
abstract: OBJECTIVE
  The involved node radiation therapy (INRT) strategy was introduced for patients with Hodgkin lymphoma (HL) to reduce the risk of late effects. With INRT, only the originally involved lymph nodes are irradiated. We present treatment outcome in a retrospective analysis using this strategy in a cohort of 97 clinical stage I-II HL patients.
  
  
  METHODS
  Patients were staged with positron emission tomography/computed tomography scans, treated with adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy, and given INRT (prechemotherapy involved nodes to 30 Gy, residual masses to 36 Gy). Patients attended regular follow-up visits until 5 years after therapy.
  
  
  RESULTS
  The 4-year freedom from disease progression was 96.4% (95% confidence interval: 92.4%-100.4%), median follow-up of 50 months (range: 4-71 months). Three relapses occurred: 2 within the previous radiation field, and 1 in a previously uninvolved region. The 4-year overall survival was 94% (95% confidence interval: 88.8%-99.1%), median follow-up of 58 months (range: 4-91 months). Early radiation therapy toxicity was limited to grade 1 (23.4%) and grade 2 (13.8%). During follow-up, 8 patients died, none from HL, 7 malignancies were diagnosed, and 5 patients developed heart disease.
  
  
  CONCLUSIONS
  INRT offers excellent tumor control and represents an effective alternative to more extended radiation therapy in the combined modality treatment for early-stage HL.
authors.affiliation: Department of Radiation Oncology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark. dra.maraldo@gmail.com
authors.forename: Maja V
authors.initials: MV
authors.lastname: Maraldo
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Aznar
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Vogelius
authors.forename: Peter M
authors.initials: PM
authors.lastname: Petersen
authors.forename: Lena
authors.initials: L
authors.lastname: Specht
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D003606:Dacarbazine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006689:Hodgkin Disease / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015182:Lymphatic Irradiation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011832:Radiation Injuries / Q000473:pathology; D011879:Radiotherapy Dosage; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin