Universität zu Köln

Sasse, Stephanie, Broeckelmann, Paul J., Goergen, Helen, Pluetschow, Annette, Mueller, Horst, Kreissl, Stefanie, Buerkle, Carolin, Borchmann, Sven, Fuchs, Michael, Borchmann, Peter, Diehl, Volker and Engert, Andreas (2017). Long-Term Follow-Up of Contemporary Treatment in Early-Stage Hodgkin Lymphoma: Updated Analyses of the German Hodgkin Study Group HD7, HD8, HD10, and HD11 Trials. J. Clin. Oncol., 35 (18). S. 1999 - 2009. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

PurposeCombined-modality treatment is widely considered the standard of care in early-stage Hodgkin lymphoma (HL), and treatment intensity has been reduced over the last years. Long-term follow-up is important to judge both efficacy and safety of the different therapies used.Patients and MethodsWe analyzed updated follow-up data on 4,276 patients treated within the German Hodgkin Study Group trials HD7 and HD10 for early-stage favorable HL and HD8 and HD11 for early-stage unfavorable HL between 1993 and 2003.ResultsIn HD7 (N = 627; median follow-up, 120 months), combined-modality treatment was superior to extended-field radiotherapy (RT), with 15-year progression-free survival (PFS) of 73% versus 52% (hazard ratio [HR], 0.5; 95% CI, 0.3 to 0.6; P < .001), without differences in overall survival (OS). In HD10 (N = 1,190; median follow-up, 98 months), noninferiority of two cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) plus 20 Gy involved-field (IF)-RT to more intensive four cycles of ABVD plus 30 Gy IF-RT was confirmed with 10-year PFS of 87% each (HR, 1.0; 95%, 0.6 to 1.5) and OS of 94% each (HR, 0.9; 95% CI, 0.5 to 1.6), respectively. In both trials, no differences in second neoplasias were observed. In HD8 (N = 1,064; median follow-up, 153 months), noninferiority of involved-field RT to extended-field RT regarding PFS was confirmed (HR, 1.0; 95% CI, 0.8 to 1.2). In HD11 (N = 1,395; median follow-up, 106 months), superiority of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone at baseline over ABVD was not observed. After BEACOPP(baseline), 20 Gy IF-RT was noninferior to 30 Gy (10-year PFS, 84% v 84%; HR, 1.0; 95% CI, 0.7 to 1.5). In contrast, PFS was inferior in ABVD-treated patients receiving 20 Gy instead of 30 Gy IF-RT (10-year PFS, 76% v 84%; HR, 1.5; 95% CI, 1.0 to 2.1). No differences in OS or second neoplasias were observed in in both trials.ConclusionLong-term follow-up data of the four randomized trials largely support the current risk-adapted therapeutic strategies in early-stage HL. Nevertheless, continued follow-up is necessary to assess the long-term safety of currently applied therapeutic strategies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sasse, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Broeckelmann, Paul J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Goergen, Helen UNSPECIFIED UNSPECIFIED UNSPECIFIED Pluetschow, Annette UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Horst UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreissl, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Buerkle, Carolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Diehl, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Engert, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-227553
DOI:	10.1200/JCO.2016.70.9410
Journal or Publication Title:	J. Clin. Oncol.
Volume:	35
Number:	18
Page Range:	S. 1999 - 2009
Date:	2017
Publisher:	AMER SOC CLINICAL ONCOLOGY
Place of Publication:	ALEXANDRIA
ISSN:	1527-7755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVOLVED-FIELD RADIOTHERAPY; 2ND CANCER-RISK; FINAL ANALYSIS; DISEASE; CHEMOTHERAPY; RADIATION; THERAPY; MALIGNANCY; SURVIVORS; DACARBAZINE Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22755