Matthew Koshy1, Shayna E Rich, Usama Mahmood, Young Kwok. 1. Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA. mkoshy@radonc.uchicago.edu
Abstract
PURPOSE: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. METHODS AND MATERIALS: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged ≥ 20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used to analyze trends. RESULTS: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). CONCLUSIONS: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.
PURPOSE: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. METHODS AND MATERIALS: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged ≥ 20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used to analyze trends. RESULTS: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). CONCLUSIONS: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.
Authors: J M Kaldor; N E Day; E A Clarke; F E Van Leeuwen; M Henry-Amar; M V Fiorentino; J Bell; D Pedersen; P Band; D Assouline Journal: N Engl J Med Date: 1990-01-04 Impact factor: 91.245
Authors: Andrea K Ng; M V Patricia Bernardo; Edie Weller; Kendall Backstrand; Barbara Silver; Karen C Marcus; Nancy J Tarbell; Mary Ann Stevenson; Jonathan W Friedberg; Peter M Mauch Journal: Blood Date: 2002-09-15 Impact factor: 22.113
Authors: S Laskar; T Gupta; S Vimal; M A Muckaden; T K Saikia; S K Pai; K N Naresh; K A Dinshaw Journal: J Clin Oncol Date: 2003-12-02 Impact factor: 44.544
Authors: S Pavlovsky; M Maschio; M T Santarelli; F S Muriel; C Corrado; I Garcia; L Schwartz; C Montero; F L Sanahuja; O Magnasco Journal: J Natl Cancer Inst Date: 1988-11-16 Impact factor: 13.506
Authors: H A Wolff; C R M Wolff; C F Hess; K Jung; S Sennhenn-Kirchner; M Hinterthaner; A Müller-Dornieden; W Körber; K Marten-Engelke; R Roedel; H Christiansen; C Engelke Journal: Strahlenther Onkol Date: 2013-07-12 Impact factor: 3.621
Authors: Melissa H LeMieux; Abhishek A Solanki; Usama Mahmood; Steven J Chmura; Matthew Koshy Journal: Cancer Med Date: 2015-01-26 Impact factor: 4.452
Authors: Hayoon Lee; Jun Won Kim; Sung Joon Hong; Seung Choul Yang; Young Deuk Choi; Koon Ho Rha; Jaeho Cho Journal: Yonsei Med J Date: 2015-01 Impact factor: 2.759
Authors: Sachin R Jhawar; Zorimar Rivera-Núñez; Richard Drachtman; Peter D Cole; Bradford S Hoppe; Rahul R Parikh Journal: JAMA Oncol Date: 2019-05-01 Impact factor: 31.777
Authors: Sally L Glaser; Christina A Clarke; Theresa H M Keegan; Ellen T Chang; Dennis D Weisenburger Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-07-27 Impact factor: 4.090