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Long-term clinical outcomes of combined modality therapy for advanced-stage Hodgkin lymphoma in the PET era: A retrospective study.

التفاصيل البيبلوغرافية
العنوان: Long-term clinical outcomes of combined modality therapy for advanced-stage Hodgkin lymphoma in the PET era: A retrospective study.
المؤلفون: Chugh S; Department of Radiation Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Panda G; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Mokal S; Department of Pathology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Jain H; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Bagal B; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Khanna N; Department of Radiation Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Epari S; Department of Clinical Research Secretariat, Tata Memorial Centre, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Punatar S; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Nayak L; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Gokarn A; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Khattry N; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Sengar M; Department of Medical Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Laskar S; Department of Radiation Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India., Goda JS; Department of Radiation Oncology, Hematolymphoid Disease Management Group, Tata Memorial Center, BARC Training School Complex, Mumbai, Maharashtra, India.; Homi Bhabha National Institute, BARC Training School Complex, Mumbai, Maharashtra, India.
المصدر: The Indian journal of medical research [Indian J Med Res] 2024 Feb 01; Vol. 159 (2), pp. 193-205. Date of Electronic Publication: 2024 Apr 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Medknow Country of Publication: India NLM ID: 0374701 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0971-5916 (Print) Linking ISSN: 09715916 NLM ISO Abbreviation: Indian J Med Res Subsets: MEDLINE
أسماء مطبوعة: Publication: <2011- > : Mumbai : Medknow
Original Publication: New Delhi : Council Of Medical Research
مواضيع طبية MeSH: Hodgkin Disease*/diagnostic imaging , Hodgkin Disease*/drug therapy, Humans ; Retrospective Studies ; Positron Emission Tomography Computed Tomography ; Dacarbazine/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Combined Modality Therapy ; Doxorubicin ; Recurrence ; Hemoglobins ; Neoplasm Staging ; Treatment Outcome
مستخلص: Background Objectives: The role of consolidation radiation therapy (CRT) after complete metabolic response to chemotherapy in advanced-stage (stage III and IV) Hodgkin lymphoma (HL) is controversial. This study was undertaken to assess the clinical outcomes in terms of event free survival, local failure free survival and overall survival in individuals with advanced HL treated with chemotherapy and CRT.
Methods: A retrospective review was conducted to study the long-term clinical outcomes in individuals diagnosed with HL and treated with chemotherapy and CRT from 2012 to 2016 at a tertiary cancer care hospital in India.
Results: Data from 203 study participants with advanced-stage HL were analyzed. Positron emission tomography-computed tomography (PET-CT) was done at baseline and after 2 cycles for response assessment. The median age at presentation was 32 yr [interquartile range (IQR): 26-46]. Early metabolic response (after 2 cycles) and delayed metabolic response (after 4 or 6 cycles) were observed in 74.4 and 25.6 per cent of individuals, respectively. With a median follow up of 52 months (IQR: 40-67), the five-year event-free survival (EFS), local failure-free survival (LFFS) and overall survival (OS) were 83.2, 95.1 and 94.6 per cent, respectively. On univariate analysis, extranodal disease was associated with inferior EFS (P=0.043). Haemoglobin <10.5 g/dl (P=0.002) and Hasenclever index >3 (P=0.00047) were associated with poorer OS. Relapses were observed in 28/203 (13.8%) study participants with predominance at central nodal stations. The median time to relapse was 19.4 months (IQR: 13-33). Local relapse alone (at the irradiated site) was observed in 5/28 study participants, systemic (distant) relapse in 14/28 individuals, while both systemic and local relapse was observed in 9/28 participants. Extranodal disease (P=0.05), bulky disease (P=0.005) and haemoglobin concentration ≤10.5 g/dl (P=0.036) were significant predictors for disease relapse.
Interpretation Conclusions: Individuals with advanced-stage HL treated with anthracycline-based chemotherapy (anthracycline-based chemotherapy with doxorubicin, bleomycin, vinblastine and dacarbazine regimen) and CRT had excellent long-term outcomes. As isolated infield failures are uncommon, selective consolidation with conformal RT to high-risk sites improves final disease outcomes.
(Copyright © 2024 Copyright: © 2024 Indian Journal of Medical Research.)
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المشرفين على المادة: 7GR28W0FJI (Dacarbazine)
80168379AG (Doxorubicin)
0 (Hemoglobins)
تواريخ الأحداث: Date Created: 20240405 Date Completed: 20240408 Latest Revision: 20240428
رمز التحديث: 20240428
مُعرف محوري في PubMed: PMC11050758
DOI: 10.4103/ijmr.ijmr_3459_21
PMID: 38577858
قاعدة البيانات: MEDLINE
الوصف
تدمد:0971-5916
DOI:10.4103/ijmr.ijmr_3459_21