TUESDAY, April 30, 2019 (Pharmacist's Briefing) -- For patients with advanced-stage Hodgkin lymphoma (HL) with large tumors, limited evidence suggests that consolidation radiotherapy (RT) after chemotherapy may prolong progression-free survival, according to a study presented at ESTRO 38, the annual meeting of the European Society for Radiotherapy and Oncology, held from April 26 to 30 in Milan.
Umberto Ricardi, M.D., from the University of Turin in Italy, and colleagues recruited 512 patients with advanced-stage HL receiving six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Those who completed the ABVD regimen and achieved a complete metabolic response were randomly assigned to receive or not receive consolidation RT to bulky lesions.
Of the 354 patients with a positron emission tomography negative finding after ABVD, 116 had a bulky lesion and were randomly assigned to RT or no further treatment (NFT). The researchers found that progression-free survival (PFS) was similar at three and five years between the RT (92 and 89 percent) and NFT arms (82 percent at both time points) in the intention-to-treat analysis. In a per-protocol analysis, the PFS for RT versus NFT was 91.7 versus 81.4 percent at three years and 88.9 versus 81.5 percent at five years (P = 0.24); these differences were not statistically significant, mainly due to the limited sample and number of events.
"The results of this trial do not provide definitive evidence on the role of radiotherapy after chemotherapy," Ricardi said in a statement. "However, the improvement in survival among those who did receive radiotherapy is not negligible."