title: Trends in Use of Radiation Therapy for Hodgkin Lymphoma From 2000 to 2012 on the Basis of the National Cancer Data Base.
abstract: BACKGROUND
  Hodgkin lymphoma (HL) has come a long way from being a disease with high mortality to being highly curable, which thereby exposes survivors to the potential for long-term toxicities. Our aim was to analyze the National Cancer Data Base for trends in radiation therapy use among all stages of HL from 2000 to 2012 and to see if increased recognition of these risks has decreased the use of radiation therapy.
  
  
  METHODS
  This was a retrospective study of patients diagnosed with HL (stage I-IV) between the years 2000 and 2012 using the National Cancer Data Base (n = 24,118). The National Cancer Data Base is a nationwide oncology outcomes database for more than 1500 American College of Surgeons Commission on Cancer accredited cancer programs. The study focused on the proportion of patients who received radiation therapy.
  
  
  RESULTS
  Between the years 2000 and 2012, use of radiation therapy declined among all stages of HL (stage I: 53% to 40%, P = .0002; stage II: 52% to 36%, P < .0001; stage III: 21% to 10%, P < .0001; stage IV: 17% to 9%; P = .0002).
  
  
  CONCLUSIONS
  There has been a significant decline in the use of radiation therapy from 2000 to 2012 among all stages of HL, perhaps because of the studies that showed an increase in late complications with use of radiation therapy.
authors.affiliation: Department of Internal Medicine, CHI Health Creighton University Medical Center, Omaha, NE. Electronic address: gauravgoyal@creighton.edu.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Goyal
authors.affiliation: Department of Hematology/Oncology, CHI Health Creighton University Medical Center, and Department of Oncology, VA Nebraska Western Iowa Healthcare System, Omaha, NE.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Silberstein
authors.affiliation: Department of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE.
authors.forename: James O
authors.initials: JO
authors.lastname: Armitage
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005260:Female; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012306:Risk; D014481:United States / Q000453:epidemiology
keywords: Adult; Cardiotoxicity; Complications; Radiotherapy; Survivors