Salvage radiotherapy was deemed safe and effective for select patients with Hodgkin lymphoma after chemotherapy failure

10-11-2006

Investigators in Australia conducted a study "to evaluate the long-term results of salvage radiotherapy (SRT) for Hodgkin lymphoma after chemotherapy failure. We reviewed 81 patients undergoing SRT for persistent or recurrent Hodgkin lymphoma after chemotherapy; 19 also received conventional-dose salvage chemotherapy. At SRT, the median patient age was 31 years."

"Of the 81 patients, 81% had Stage I-II, 25.9% had B symptoms, 14.8% had bulky disease, and 7.4% had extranodal disease. A less than a complete response (CR) to the last chemotherapy regimen occurred in 47%. SRT was generally limited to one side of the diaphragm, and the median dose was 36 Gy. After SRT, 75% of patients achieved a CR, with 82% retaining durable in-field control. In-field failure was associated with less than a CR to the last chemotherapy regimen (p=.0287). Most failures were at distant sites, with 60% in previously involved sites," explained B. Campbell and colleagues, Peter MacCallum Cancer Institute.

"The 10-year freedom from treatment failure and overall survival rates were 32.8% and 45.7%, respectively. The adverse prognostic factors for freedom from treatment failure were age >50 years (p<.001), B symptoms (p<.001), extranodal disease (p=.012), and less than a CR to the last chemotherapy regimen (p=.001). The adverse prognostic factors for overall survival were male gender (p=.034), age >50 years (p<.001), B symptoms (p=.002), and less than a CR to the last chemotherapy regimen (p=.002). Favorable cohorts had a 10-year freedom from treatment failure rate of 51% and overall survival rate of 92%."

The researchers concluded, "Salvage radiotherapy is effective for selected patients with Hodgkin lymphoma after chemotherapy failure and should be considered for incorporation into salvage programs."

Campbell and colleagues published their study in International Journal of Radiation Oncology Biology Physics (Long-term follow-up of salvage radiotherapy in Hodgkin's lymphoma after chemotherapy failure. Int J Radiat Oncol Biol Phys, 2005;63(5):1538-1545).

For additional information, contact A. Wirth, Peter MacCallum Cancer Institute, Dept. Radiation Oncology, Locked Bag 1, A Beckett St., St. Andrews Pl, Melbourne, Vic 8006, Australia.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.