title: Early-stage nodular lymphocyte-predominant Hodgkin lymphoma: the impact of radiotherapy on overall survival.
abstract: The purpose of this study was to use the National Cancer Database to examine the association between radiation therapy (RT) and overall survival (OS) in early-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) using standard and propensity score (PS)-adjusted Cox proportional hazards models. From 1998-2011, 1915 patients with stage I/II NLPHL were studied, with a median follow-up of 6.6 years (median age = 44). Of the cohort, 1224(64%) received RT (alone or with chemotherapy) to a median dose of 30.6 Gy. Patients were more likely to receive RT if male, younger age, lower stage, no "B"-symptoms, favorably insured, and treatment at comprehensive centers (all p < 0.05). Patients administered RT had an improved 5-year OS (HR = 0.62; 95%CI, 0.43-0.89, p = 0.01). After PS-matching (n = 868) based on all known co-variates, RT use trended towards improved OS (HR = 0.49; 95%CI, 0.23-1.05, p = 0.06). This study represents one of the largest prospective datasets examining the role of RT for stage I/II NLPHL and inclusion of RT may be considered.
authors.affiliation: a Mount Sinai Beth Israel Medical Center & Mount Sinai St. Luke's-Roosevelt Hospitals, Mount Sinai Health System , Department of Radiation Oncology , New York , NY , USA.
authors.forename: Rahul R
authors.initials: RR
authors.lastname: Parikh
authors.affiliation: b Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, Division of Hematology and Oncology , New York , NY , USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Grossbard
authors.affiliation: c Moffitt Cancer Center and Research Institute , Department of Radiation Oncology , Tampa , FL , USA.
authors.forename: Louis B
authors.initials: LB
authors.lastname: Harrison
authors.affiliation: d Memorial Sloan-Kettering Cancer Center , Department of Radiation Oncology , New York , NY , USA.
authors.forename: Joachim
authors.initials: J
authors.lastname: Yahalom
keywords: Lymphocyte-predominant Hodgkin lymphoma; National Cancer Database; overall survival; radiotherapy