Poorer outcome of elderly patients treated with extended-field radiotherapy compared with involved-field radiotherapy after chemotherapy for Hodgkin's lymphoma: an analysis from the German Hodgkin Study Group

Abstract

Elderly patients with early-stage unfavorable HL generally have a poorer risk profile and outcome when compared with younger patients. Treatment with EF-RT instead of IF-RT after chemotherapy has a negative impact on survival of elderly patients and should be avoided.

The Unique Characteristics and Management of Patients Over 60 Years of Age with Classic Hodgkin Lymphoma

“…Interestingly the outcome in older patients was poorer when they were treated with EF-RT instead of IF-RT (FFTF, 58% vs 70%, P=0.034; OS, 59% vs 81%, P=0.008). Furthermore, increased toxicity was documented when the older patients received EF-RT [40]. In conclusion, EF-RT should be avoided in treating older patients.…”

Treatment of Early Stage Hodgkin Lymphoma

“…For patients with early stage unfavorable HL, Klimm et al (Klimm, Eich, Haverkamp, et al, 2007) reported in 2007 the GHSC experience for the elderly early stage HL after CMT with 4 cycles of chemotherapy (COPP/ABVD) followed by EF-RT vs. IF-RT. From 1204 patients enrolled in the GHSG HD8 study, 89 patients were 60 years or older.…”

Classical Hodgkin's lymphoma in adults: guidelines of the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation on initial work-up, management, and follow-up

“…The EP recommendations are, therefore, based on the analysis of retrospective studies or on data extracted from sub-groups of elderly patients enrolled into trials originally designed for younger patients. Data extrapolated from the HD8 GHSG study 58 indicate that in patients with early stage disease, without co-morbidities, 2-4 courses of chemotherapy with ABVD followed by limited radiotherapy are well tolerated and produce a high complete remission rate. Extended RT has a negative impact in elderly patients and only limited RT should therefore be adopted as adjuvant to chemotherapy in this category of patients.…”