According to results presented at the 47th annual meeting of the American Society of Therapeutic Radiation Oncology (ASTRO), drastically reducing radiation doses may be as effective as higher doses in the treatment of early Hodgkin’s lymphoma. These reduced doses may prevent potentially debilitating long-term side effects.
Lymphomas are a malignancy in which cancerous cells form in the cells of the lymphatic system. The lymphatic system is a drainage system within the body whose two primary functions are to maintain fluid balance and produce cells called lymphocytes, which fight infection. Lymphomas are divided into two types: non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. Hodgkin’s lymphoma is characterized by the presence of Reed-Sternberg cells. Current treatment options for Hodgkin’s lymphoma include surgery, chemotherapy, and radiation.
Early Hodgkin’s lymphoma refers to cancer that is not advanced enough to produce “bulky” sites and has not invaded vital organs. Cure rates are high with standard treatment; researchers are now focusing on ways to maintain these high cure rates while reducing side effects (particularly long-term side effects) caused by treatment.
Although chemotherapy plus radiation therapy tends to be a standard approach for the treatment of early Hodgkin’s, research continues to evaluate whether early Hodgkin’s may be cured with either approach alone. Researchers are also evaluating different doses of radiation therapy and different chemotherapy combinations to reduce side effects.
Researchers in Germany recently conducted a clinical trial to evaluate drastically reduced radiation doses given in addition to chemotherapy in the treatment of early Hodgkin’s. This study included 1,131 patients who were treated between 1998 and 2002. Patients were treated with a radiation dose of 20 Gy (versus the historical 30 Gy) plus the standard chemotherapy combination referred to as ABVD. Reduced radiation doses appeared promising:
- 98% of patients experienced a complete disappearance of detectable cancer (complete remission).
- Only 2.5% of patients experienced a cancer recurrence during two years of observation.
The researchers concluded that significantly reducing radiation doses appear as effective as higher doses of radiation when combined with ABVD in the treatment of early Hodgkin’s. However, longer follow-up is necessary to provide more information on long-term survival. In addition, some studies have indicated that chemotherapy alone may provide effective results in the treatment of early-stage Hodgkin’s. Patients with early Hodgkin’s lymphoma may wish to speak with their physician regarding their individual risks and benefits of different treatment regimens.
Reference: Eich T, et al. Comparison of 30 Gy Versus 20 Gy Involved Field Radiotherapy After Two Versus Four Cycles ABVD in Early-Stage Hodgkin’s Lymphoma: Interim Analysis of the German Hodgkin Study Group Trial HD10. Proceedings from the 47th annual meeting of the American Society of Therapeutic Radiation Oncology (ASTRO). Presented October 17, 2005. Denver, Colorado.