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Annals of Oncology Advance Access published online on August 10, 2005
Annals of Oncology, doi:10.1093/annonc/mdi323
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© 2005 European Society for Medical Oncology
Received April 2, 2005
Revised June 1, 2005
Accepted June 17, 2005

Original article

Extended field radiotherapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin's lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG)

L. Nogová 1*, T. Reineke 1, H. T. Eich 2, A. Josting 1, H. K. Müller-Hermelink 3, K. Wingbermühle 1, C. Brillant 1, A. Gossmann 4, J. Oertel 5, M. V. Bollen 6, R.-P. Müller 2, V. Diehl 1, A. Engert 1, and for the GHSG 7

1 Clinic I for Internal Medicine, University Hospital Cologne
2 Clinic of Radiotherapy, University Hospital Cologne
3 Insitut for Pathology of University Wuerzburg
4 Department of Radiology of University Hospital Cologne
5 Campus Virchow Klinikum, Berlin
6 University Hospital Heidelberg, Heidelberg, Germany
7 The German Hodgkin Lymphoma Study Group (GHSG)

* To whom correspondence should be addressed.
L. Nogová, E-mail: lucia.nogova{at}uk-koeln.de


  Abstract

Background: Since there are no randomized studies, the treatment of choice for patients with early stage lymphocyte-predominant Hodgkin's lymphoma (LPHL) remains unclear. We thus reviewed all LPHL cases registered in the database of the German Hodgkin Study Group (GHSG) and compared the different treatment approaches, such as extended field (EF), involved field (IF) radiation and combined modality (CM) treatment for LPHL stage IA patients.

Patients and methods: One hundred and thirty-one patients with LPHL in clinical stage IA without risk factors were analyzed. Forty-five patients were treated with EF radiotherapy, 45 patients with IF radiation and 41 patients received CM treatment. The median follow-up was 78 months in the EF group, 40 months after CM and 17 months after IF, respectively.

Results: A total of 129 patients achieved complete remission (CR and CRu): 98% after EF radiotherapy, 100% after IF radiation and 95% after CM. With a median follow-up of 43 months there were 5% relapses and only three patients died. Toxicity of treatment was generally mild with most events observed after CM.

Conclusion: In terms of remission induction IF radiotherapy for stage IA LPHL patients is as effective as EF or CM treatment. However, longer follow-up is needed before final conclusion as the optimal therapy.

Keywords: combined modality treatment; extended field radiotherapy; involved field radiotherapy; lymphocyte-predominant Hodgkin's lymphoma.
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