Hodgkin’s lymphoma; late effects; radiotherapy; dose; volume
Abstract :
[en] Treatment–related late complications on nontarget
normal tissues and appearance of secondary
malignancies are well known side-effects
induced by effective treatment regimens currently
used in the curative approach of early and
advanced Hodgkin’s lymphoma. Radiotherapy
(RT) and chemotherapy (CT) can lead to these
late complications. Efforts have been conducted
to reduce the morbidity and mortality related
to these treatments. In particular there has
been a progressive shift from radiotherapy used
as sole modality to chemotherapy as first line
followed by consolidation radiotherapy. As the
side-effects of radiotherapy are linked to dose,
volume and interaction with chemotherapy,
trials have been launched to assess the impact
of modifying the characteristics of the radiation
treatment. For early-stage Hodgkin’s lymphoma
radiotherapy cannot be avoided but dose and
volume can be reduced. In advanced Hodgkin’s
lymphoma omitting radiotherapy seems reasonable
only in case of complete response (CR). The
clinical trials allowing such a paradigm shift are
highlighted in this review.
Disciplines :
Oncology Hematology
Author, co-author :
Coucke, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Barthelemy, Nicole ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Hustinx, Roland ; Centre Hospitalier Universitaire de Liège - CHU > Médecine nucléaire
Fillet, Georges ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Language :
English
Title :
Risk adaptive treatment in Hodgkin's lympoma: reduction of radiation dose and irradiated volume
