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Post-Chemo Radiation May Not Be Needed in Early Hodgkin's

For patients with negative PET after chemo, no further treatment was not noninferior to radiation

THURSDAY, April 23, 2015 (HealthDay News) -- For patients with early Hodgkin's lymphoma who have negative findings on positron-emission tomography (PET) after three cycles of chemotherapy, progression-free survival is similar with or without further radiation, according to a study published in the April 23 issue of the New England Journal of Medicine.

John Radford, M.D., from the University of Manchester in the United Kingdom, and colleagues assessed the noninferiority of no further treatment for patients with newly diagnosed stage IA or stage IIA Hodgkin's lymphoma who received three cycles of chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine and had negative findings on PET. Four hundred twenty patients with negative PET findings were randomized to receive involved-field radiotherapy (209 patients) or no further treatment (211 patients).

At a median of 60 months of follow-up, the researchers observed eight instances of disease progression and eight patients had died (three with disease progression) in the radiotherapy group, compared with 20 instances of progression and four patients who died (two with disease progression) in the no further treatment group. Five of the deaths in the radiotherapy group occurred in patients who received no radiotherapy. Three-year progression-free survival was 94.6 and 90.8 percent in the radiotherapy and no further intervention groups, respectively (absolute risk difference, −3.8 percent).

"Although the noninferiority margin was exceeded in this study, the results suggest that radiotherapy can be avoided for patients with negative PET findings," the authors write.

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