Mario Levis1, Cristina Piva2, Andrea Riccardo Filippi2, Barbara Botto3, Paolo Gavarotti3, Patrizia Pregno3, Maura Nicolosi3, Roberto Freilone4, Guido Parvis5, Daniela Gottardi6, Umberto Vitolo3, Umberto Ricardi2. 1. Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy. Electronic address: mariolevis82@gmail.com. 2. Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy. 3. Department of Hematology, A.O.U. Città della Salute e della Scienza, Torino, Italy. 4. Department of Hematology, Ospedale Civile, Ciriè, Torino, Italy. 5. Department of Internal Medicine and Hematology, San Luigi Hospital, Orbassano, Torino, Italy. 6. Department of Hematology, Mauriziano Hospital, Torino, Italy.
Abstract
INTRODUCTION: We investigated for a possible role for peritransplantation involved-field radiotherapy (IFRT) by comparing patients who received IFRT before after autologous stem cell transplantation (ASCT) and patients who received salvage chemotherapy (CT) alone. PATIENTS AND METHODS: We retrospectively evaluated 73 consecutive patients with Hodgkin lymphoma treated with ASCT between 2003 and 2014. Twenty-one patients (28.8%) received peritransplantation radiotherapy. A Cox regression analysis (multivariate analysis; MVA) was performed to evaluate the prognostic role of any risk factor. Overall survival (OS) and progression-free survival (PFS) were calculated from the date of ASCT. Response to CT and ASCT were evaluated with positron emission tomography (PET) scan. RESULTS: Median follow-up was 41 months (range, 1-136 months). Overall, no significant difference appeared between patients who received IFRT and patients treated with CT alone; however, patients who were treated with IFRT had worse prognostic factors. In the MVA, advanced stage at relapse and persistent disease before ASCT (evident on PET scan [PET+]) were related to worse PFS and OS. In patients with limited stage disease at relapse and PET+, peritransplantation radiotherapy showed higher 3-year OS rates (91.7% vs. 62.3%) and PFS rates (67.5% vs. 50%) compared with patients treated with CT alone, although this difference was not significant (P = .14 and P = .22, respectively). CONCLUSION: IFRT used before or after ASCT might partially compensate for worse prognostic factors among the overall population; subgroup analysis showed a trend for survival benefit at 3 years in patients with limited stage disease at relapse and PET+ before ASCT.
INTRODUCTION: We investigated for a possible role for peritransplantation involved-field radiotherapy (IFRT) by comparing patients who received IFRT before after autologous stem cell transplantation (ASCT) and patients who received salvage chemotherapy (CT) alone. PATIENTS AND METHODS: We retrospectively evaluated 73 consecutive patients with Hodgkin lymphoma treated with ASCT between 2003 and 2014. Twenty-one patients (28.8%) received peritransplantation radiotherapy. A Cox regression analysis (multivariate analysis; MVA) was performed to evaluate the prognostic role of any risk factor. Overall survival (OS) and progression-free survival (PFS) were calculated from the date of ASCT. Response to CT and ASCT were evaluated with positron emission tomography (PET) scan. RESULTS: Median follow-up was 41 months (range, 1-136 months). Overall, no significant difference appeared between patients who received IFRT and patients treated with CT alone; however, patients who were treated with IFRT had worse prognostic factors. In the MVA, advanced stage at relapse and persistent disease before ASCT (evident on PET scan [PET+]) were related to worse PFS and OS. In patients with limited stage disease at relapse and PET+, peritransplantation radiotherapy showed higher 3-year OS rates (91.7% vs. 62.3%) and PFS rates (67.5% vs. 50%) compared with patients treated with CT alone, although this difference was not significant (P = .14 and P = .22, respectively). CONCLUSION: IFRT used before or after ASCT might partially compensate for worse prognostic factors among the overall population; subgroup analysis showed a trend for survival benefit at 3 years in patients with limited stage disease at relapse and PET+ before ASCT.
Authors: Joshua C Farris; Alex Ritter; Michael D Craig; Nilay Shah; Lauren Veltri; Abraham S Kanate; Kelly Ross; John A Vargo Journal: Pract Radiat Oncol Date: 2018-12-21