A Contribution to Solve the Problem of the Need for Consolidative Radiotherapy after Intensive Chemotherapy in Advanced Stages of Hodgkin's Lymphoma—Analysis of a Quality Control Program Initiated by the Radiotherapy Reference Center of the German Hodgkin Study Group (GHSG)

Eich, Hans Theodor; Goßmann, Axel; Engert, Andreas; Kříž, Jan; Bredenfeld, Henning; Hansemann, K.; Skripnitchenko, R.; Brillant, Corinne; Pfistner, Beate; Staar, Susanne; Diehl, Volker; Müller, Rolf-Peter

doi:10.1016/j.ijrobp.2007.04.035

Cited by 31 publications

(15 citation statements)

References 15 publications

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“…This procedure was established within the HD12 trial of the GHSG; the feasibility and workflow of this quality assurance program, as well as the assessment criteria of PET in the HD15 trial, have been described previously (13,14).…”

Section: Central Review Panelmentioning

confidence: 99%

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Kříž

Reinartz

Dietlein

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Section: Central Review Panelmentioning

confidence: 99%

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Kříž

Reinartz

Dietlein

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…[6][7][8] More recently, smaller studies suggested that positron emission tomography (PET) using [ 18 F]-fluorodeoxyglucose (FDG) might discriminate between active and inactive tissue in HL, suggesting a high negative predictive value (NPV) for FDG-PET in this malignancy. [9][10][11] Thus, the GHSG HD15 study for advancedstage HL included a PET question (HD15-PET) evaluating the NPV of PET in patients after BEACOPP.…”

Section: Introductionmentioning

confidence: 99%

Positron emission tomography has a high negative predictive value for progression or early relapse for patients with residual disease after first-line chemotherapy in advanced-stage Hodgkin lymphoma

Kobe

Dietlein

Franklin

et al. 2008

Blood

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In the HD15 trial of the German Hodgkin Study Group, the negative predictive value (NPV) of positron emission tomography (PET) using [ 18 F]-fluorodeoxyglucose in advanced-stage Hodgkin lymphoma (HL) was evaluated. A total of 817 patients were enrolled and randomly assigned to receive BEACOPP-based chemotherapy. After completion of chemotherapy, residual disease measuring more than or equal to 2.5 cm in diameter was assessed by PET in 311 patients. The NPV of PET was defined as the proportion of PET ؊ patients without progression, relapse, or irradiation within 12 months after PET review panel. The progression-free survival was 96% for PET ؊ patients (95% confidence interval [CI], 94%-99%) and 86% for PET ؉ patients (95% CI, 78%-95%, P ‫؍‬ .011). The NPV for PET in this analysis was 94% (95% CI, 91%-97%). Thus, consolidation radiotherapy can be omitted in PET ؊ patients with residual disease without increasing the risk for progression or early relapse compared with patients in complete remission. The impact of this finding on the overall survival at 5 years must be awaited. Until then, response adapted therapy guided by PET for HL patients seems to be a promising approach that should be further evaluated in clinical trials. This trial is registered at http://isrctn.org study as #IS-RCTN32443041.(Blood. 2008;112: 3989-3994)

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“…It may be possible to avoid radiotherapy altogether in a proportion of patients with both early and advanced stage HL, thus reducing the detrimental long-term sequelae of treatment for these individuals. The challenge is to identify with precision those patients in whom SRT is absolutely required for optimal disease control and those in whom SRT can be safely omitted (Meyer et al, 2005;Diehl, 2007;Eich et al, 2007;Picardi et al, 2007). Studies to determine the role of FDG-PET imaging in this process are underway and promising interim results have been reported (Radford et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

The UK national breast cancer screening programme for survivors of Hodgkin lymphoma detects breast cancer at an early stage

et al. 2009

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BACKGROUND: Supradiaphragmatic radiotherapy (SRT) to treat Hodgkin's lymphoma (HL) at a young age increases the risk of breast cancer (BC). A national notification risk assessment and screening programme (NRASP) for women who were treated with SRT before the age of 36 years was instituted in the United Kingdom in 2003. In this study, we report the implementation and screening results from the largest English Cancer Network. METHODS: A total of 417 eligible women were identified through cancer registry/hospital databases and from follow-up (FU) clinics. Screening results were collated retrospectively, and registry searches were used to capture BC cases. RESULTS: Of the 417 women invited for clinical review, 243 (58%) attended. Of these 417 women, 23 (5.5%) have been diagnosed with BC, a standardised incidence ratio of 2.9 compared with the age-matched general population. Of five invasive BCs diagnosed within the NRASP, none involved axillary lymph nodes compared with 7 of 13 (54%) diagnosed outside the programme (Po0.10). The mean latency for BC cases was 19.5±8.35 years and the mean FU duration for those unaffected by BC was 14.6±9.11 years (Po0.01), suggesting that those unaffected by BC remain at high risk. Recall and negative biopsy rates were acceptable (10.5 and 0.8%, respectively). CONCLUSIONS: The NRASP appears to detect BC at an early stage with acceptable biopsy rates, although numbers are small. Determination of NRASP results on a national basis is required for the accurate evaluation of screening efficacy in women previously treated with SRT.

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A Contribution to Solve the Problem of the Need for Consolidative Radiotherapy after Intensive Chemotherapy in Advanced Stages of Hodgkin's Lymphoma—Analysis of a Quality Control Program Initiated by the Radiotherapy Reference Center of the German Hodgkin Study Group (GHSG)

Cited by 31 publications

References 15 publications

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

Positron emission tomography has a high negative predictive value for progression or early relapse for patients with residual disease after first-line chemotherapy in advanced-stage Hodgkin lymphoma

The UK national breast cancer screening programme for survivors of Hodgkin lymphoma detects breast cancer at an early stage

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