In Stage 1A Hodgkin Lymphoma, Involved-field Radiotherapy Should Be Standard of Care

Involved-field radiotherapy (IF-RT) should be considered as standard of care for patients with stage 1A nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), a new study published online ahead of print in the Journal of Clinical Oncology has shown.

Because the optimal treatment of stage IA NLPHL has not been well-defined, researchers sought to compare the safety and efficacy of combined-modality treatment (CMT), extended-field radiotherapy (EF-RT), IF-RT, and rituximab using the German Hodgkin Study Group database.

Researchers identified 256 patients with stage 1A NLPHL. Of those, 72 received CMT, 49 underwent EF-RT, 108 underwent IF-RT, and 27 received four weekly standard doses of rituximab.

Results showed that tumor control was equivalent with CMT, EF-RT, and IF-RT in terms of 8-year progression-free survival and overall survival; however, IF-RT is associated with the lowest risk for development of toxicities.

Researchers note that rituximab alone is associated with an increased risk of relapse in this patient population.

The study also demonstrated that 6.6% of patients in this analysis developed a second malignancy during the 91 months of median follow-up.

Reference

1. Eichenauer DA, Plutschow A, Fuchs M, et al. Long-term course of patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma: a report from the German Hodgkin Study Group. J Clin Oncol. 2015. [epub ahead of print]. doi: 10.1200/JCO.2014.60.4363.