title: Potential Benefit of Involved-Field Radiotherapy for Patients With Relapsed-Refractory Hodgkin's Lymphoma With Incomplete Response Before Autologous Stem Cell Transplantation.
abstract: We investigated for a possible role for peritransplantation involved-field radiotherapy (IFRT) by comparing patients who received IFRT before after autologous stem cell transplantation (ASCT) and patients who received salvage chemotherapy (CT) alone.
  
  
  
  We retrospectively evaluated 73 consecutive patients with Hodgkin lymphoma treated with ASCT between 2003 and 2014. Twenty-one patients (28.8%) received peritransplantation radiotherapy. A Cox regression analysis (multivariate analysis; MVA) was performed to evaluate the prognostic role of any risk factor. Overall survival (OS) and progression-free survival (PFS) were calculated from the date of ASCT. Response to CT and ASCT were evaluated with positron emission tomography (PET) scan.
  
  
  
  Median follow-up was 41 months (range, 1-136 months). Overall, no significant difference appeared between patients who received IFRT and patients treated with CT alone; however, patients who were treated with IFRT had worse prognostic factors. In the MVA, advanced stage at relapse and persistent disease before ASCT (evident on PET scan [PET+]) were related to worse PFS and OS. In patients with limited stage disease at relapse and PET+, peritransplantation radiotherapy showed higher 3-year OS rates (91.7% vs. 62.3%) and PFS rates (67.5% vs. 50%) compared with patients treated with CT alone, although this difference was not significant (P = .14 and P = .22, respectively).
  
  
  
  IFRT used before or after ASCT might partially compensate for worse prognostic factors among the overall population; subgroup analysis showed a trend for survival benefit at 3 years in patients with limited stage disease at relapse and PET+ before ASCT.
authors.affiliation: Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy. Electronic address: mariolevis82@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Levis
authors.affiliation: Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Piva
authors.affiliation: Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy.
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Filippi
authors.affiliation: Department of Hematology, A.O.U. Città della Salute e della Scienza, Torino, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Botto
authors.affiliation: Department of Hematology, A.O.U. Città della Salute e della Scienza, Torino, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gavarotti
authors.affiliation: Department of Hematology, A.O.U. Città della Salute e della Scienza, Torino, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pregno
authors.affiliation: Department of Hematology, A.O.U. Città della Salute e della Scienza, Torino, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Nicolosi
authors.affiliation: Department of Hematology, Ospedale Civile, Ciriè, Torino, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Freilone
authors.affiliation: Department of Internal Medicine and Hematology, San Luigi Hospital, Orbassano, Torino, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Parvis
authors.affiliation: Department of Hematology, Mauriziano Hospital, Torino, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Gottardi
authors.affiliation: Department of Hematology, A.O.U. Città della Salute e della Scienza, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
authors.affiliation: Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006689:Hodgkin Disease / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D049268:Positron-Emission Tomography / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods
keywords: Autologous stem cell transplant; Hodgkin's lymphoma; Involved field radiotherapy; Peritransplant radiotherapy; Prognostic factors