Annals of Oncology Advance Access originally published online on June 1, 2006
Annals of Oncology 2006 17(8):1290-1295; doi:10.1093/annonc/mdl094
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© 2006 European Society for Medical Oncology
A population-based cohort study on early-stage Hodgkin lymphoma treated with radiotherapy alone: with special reference to older patients
1 Hematology Center, Department of Medicine, Karolinska University Hospital and Institutet, Solna, Stockholm, Sweden; 2 Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA; 3 Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA; 4 Department of Pathology, Karolinska University Hospital and Institutet, Solna, Stockholm, Sweden
* Correspondence to: Dr O. Landgren, Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Bldg. EPS/Room 7110, Bethesda, MD 20892–7236, USA. Tel: +1 (301) 496-5786; Fax: +1 (301) 402-4489; E-mail: landgreo{at}mail.nih.gov
Background: Combined modality treatment has reduced the risk of relapse among younger early-stage Hodgkin lymphoma (HL) patients. Older HL patients may not tolerate chemotherapy and their prognosis is less favorable. We conducted a population-based study to evaluate long-term follow-up outcome in older early-stage HL patients initially treated with radiotherapy (RT) alone.
Patients and methods: We included 308 consecutive patients (22% were 
60 years) diagnosed 1972–1999 (median follow-up 20 years; range 1–28). Using Cox regression models we defined risk of relapse and survival in relation to clinical factors.
Results: 272/308 (88%) patients obtained complete remission following first-line RT alone. Among these, 42% relapsed within a median of 21 months. The relapse rate was independent of gender and age at diagnosis (median age 32 years, range 14–85); however, lymphocyte-predominant HL was associated with borderline (P = 0.049) 56% decreased risk of relapse. Among patients <60 years and 60 years, we observed 29 (median latency 10 years, range 2–25) and 11 (median latency 3 years, range 1–10) second tumors, respectively.
Conclusions: Older age (60 years) was not associated with an increased risk of relapse following RT alone. Given the risks of iatrogenic morbidity/mortality of chemotherapy in older patients, RT alone could be an alternative first-line therapy in early-stage older HL patients.
Key words: elderly, Hodgkin lymphoma, late complications, radiotherapy, relapse