Features | Partner Sites | Information | LinkXpress
Sign In
ElsMed
Ampronix
Schiller

Early PET-Negative Stage I/II Hodgkin Lymphoma Patients Show Increased Risk of Early Relapse when Radiotherapy Is Not Used

By Medimaging International staff writers
Posted on 23 Apr 2014
Image: Micrograph of Hodgkin lymphoma. Lymph node fine-needle aspiration (FNA) specimen. Field stain (Photo courtesy of Wikimedia Commons).
Image: Micrograph of Hodgkin lymphoma. Lymph node fine-needle aspiration (FNA) specimen. Field stain (Photo courtesy of Wikimedia Commons).
Analysis of a new study indicates an increased risk of early relapse when excluding radiotherapy in early positron emission tomography (PET) scan-negative patients with stage I/II Hodgkin’s lymphoma.

The interim analysis of the intergroup EORTC-LYSA-FIL 20051 H10 trial was published online March 17, 2014, in the Journal of Clinical Oncology. Early outcome, however, was excellent in both arms, and the final analysis should reveal whether these preliminary findings are upheld over time.

Dr. J.M.M. Raemaekers, from the Radboud University Medical Center (Nijmegen, The Netherlands), and central coordinator of the study stated, “The standard treatment for patients with clinical stage I/II Hodgkin’s lymphoma is ABVD [adriamycin, bleomycin, vinblastin and dacarbazin] chemotherapy followed by radiotherapy. Striking the right balance between initial cure through combined modality treatment and accepting a higher risk of late complications, and a higher recurrence rate after omitting radiotherapy in subsets of patients who will subsequently need intensive salvage treatment, is a matter of unsettled debate.”

The main objective of the H10 trial was to evaluate whether involved-node radiotherapy could be omitted without loss of efficacy in terms of progression-free survival in patients with stage I/II Hodgkin’s lymphoma who had a negative early PET scan after two cycles of ABVD chemotherapy. This interim trial analysis included a total of 1,137 patients with untreated clinical stage I/II Hodgkin’s lymphoma. Of these, 444 patients had favorable and 693 unfavorable prognoses. Patients in each prognostic group were randomized between standard and experimental treatment and first received two cycles of ABVD chemotherapy. Patients in the experimental arm who attained a negative early PET scan after the two cycles of ABVD chemotherapy were spared involved-node radiotherapy.

One progression occurred in the standard arm and nine progressions occurred in the research arm, for patients with a favorable prognosis and a negative early PET scan. For patients with unfavorable prognosis and a negative early PET scan, seven events occurred in the standard arm and 16 events occurred in the research arm. Even though there were few events and the median follow-up time short, the Independent Data Monitoring Committee concluded it was unlikely that the final results would show noninferiority for the experimental treatment. They, therefore, advised that randomization should be stopped for early PET-negative patients.
The study was closed for recruitment in June 2011 with a total of 1952 patients. The intergroup EORTC 20051 H10 trial is coordinated by the EORTC Lymphoma Group in collaboration with the LYmphoma Study Association (LYSA) and the Fondazione Italiana Linfomi (FIL). It is being conducted in 159 sites in eight countries: Belgium, Croatia, Denmark, France, Italy, Slovakia, Switzerland, and The Netherlands.

Related Links:

Radboud University Medical Center



Channels

Radiography

view channel

Healthcare Costs Could Be Cut by More Appropriate Use of Cardiac Stress Imaging

In new research, investigators concluded that overuse of cardiac stress testing using advanced imaging technology has led to increasing healthcare costs in the United States and unnecessary radiation exposure to patients. Researchers from the New York University Langone Medical Center (NYU; New York, NY, USA), in... Read more

MRI

view channel
Image: MagLab’s 900 MHz magnet (Photo courtesy of FSU – Florida State University).

High Magnetic Field MRI Technology Provides Comprehensive Analysis of Strokes

A new, novel way to categorize the severity of a stroke, help in diagnosis, and assesse potential treatments has been demonstrated by US researchers. “Stroke affects millions of adults and children... Read more

Ultrasound

view channel
Image: Leading German anesthetists Drs. Wolf Armbruster, Rüdiger Eichholz, and Thomas Notheisen have collaborated to develop the Armbruster Eichholz Notheisen (AEN) training concept for ultrasound-guided regional anesthesia (Photo courtesy of Management and Krankenhaus).

Point-of-Care Ultrasound Training Program Established for Regional Anesthesiologists

Regional anesthesia specialists have developed an innovative ultrasound training program. Leading German anesthetists Drs. Wolf Armbruster, Rüdiger Eichholz, and Thomas Notheisen have collaborated to... Read more

General/Advanced Imaging

view channel
Image: A collaborative effort between EPFL, CNRS, ENS Lyon, CPE Lyon, and ETH Zürich has led to the development of a novel approach that can considerably improve the capabilities of medical imaging with safer procedures for the patient (Photo courtesy of EPFL - Ecole Polytechnique Fédérale de Lausanne).

Collaboration to Make Diagnostic Medical Imaging Less Hazardous Using Hyperpolarization Agents

A collaborative effort by scientists has led to the development of an innovative strategy that can considerably improve the capabilities of medical imaging with safer procedures for the patient.... Read more

Imaging IT

view channel

Tabbed Barcodes and Management System Software Designed to Help Apron Tracking to Improve Radiology Inventory Management

A web-based inventory management system has been designed to link each radiology apron with a distinct barcode ID. As a cloud-based, decision support system, staff can track, audit, and maintain aprons using data sorted by department, area, and garment type. Healthcare personnel can see details on individual inspections... Read more

Industry News

view channel

Global Partnership Provides Treatment Planning Support for Modulated Arc Radiotherapy

Varian Medical Systems (Palo Alto, CA, USA) Eclipse treatment planning software can now be used to plan modulated arc radiotherapy (mARC) treatments at sites using Siemens Healthcare (Erlangen, Germany) medical linear accelerators. Varian Medical Systems and Siemens Healthcare presented their range of solutions that... Read more
 
Copyright © 2000-2014 Globetech Media. All rights reserved.