Chemotherapy alone or combined chemotherapy and involved field radiotherapy in favorable risk early-stage classical Hodgkin lymphoma-a 10 years experience

Background

Early-stage Hodgkin lymphoma is divided into favorable and unfavorable disease. Trials for patients with limited-stage HL have demonstrated that treatment with chemotherapy plus involved-field radiation therapy (IFRT) and chemotherapy alone with Doxorubicin (Adriamycin), Bleomycin, Vinblastine, and Dacarbazine (ABVD) may both be acceptable options. The aim of this study was to determine the outcomes of favorable risk early-stage Hodgkin lymphoma treated either with chemotherapy alone or chemotherapy plus IFRT.

Methods

Retrospective study done on newly diagnosed patients of early-stage classical HL with favorable risk prognostic features. Patients were divided in 2 groups i.e chemotherapy alone or combined modality treatment (CMT) comprising of chemotherapy followed by radiotherapy. Baseline characteristics in both groups were compared using cross tab and chi square test. PFS and OS for both groups was calculated using survival curves.

Results

Out of 101 patients, 71.3% were male. Sixty three (62.4%) patients received CMT and 38 (37.6%) patients had chemotherapy alone. Radiotherapy dose was 20 to 36 gray. Patients treated with CMT had OS compared to chemotherapy alone: 100% versus 91% at 5 years and 96% versus 81% at 10 years respectively (p = 0.03). PFS with CMT against chemotherapy alone at 5 years (98% versus 81%) and 10 years (82% versus 71%) (p = 0.01).

Conclusions

Patients treated with CMT had better progression free survival and overall survival compared to chemotherapy alone.

Clinical trial identification

Legal entity responsible for the study

Shaukat Khanum Memorial Cancer Hospital and research Centre, Lahore, Pakistan was responsible for the governance, coordination and running of the study.

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.