Tom 5, Nr 1 (2020)
Debaty onkologiczne
Opublikowany online: 2020-03-05

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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Czy u chorych na wczesnego chłoniaka Hodgkina należy stosować uzupełniającą radioterapię? Głos na tak

Ewelina Łata-Woźniak12, Aleksandra Łacko12
Biuletyn Polskiego Towarzystwa Onkologicznego Nowotwory 2020;5(1):31-34.

Streszczenie

Chłoniak Hodgkina należy do najbardziej promieniowrażliwych i chemiowrażliwych nowotworów. Radioterapia pełni kluczową rolę w jego leczeniu we wczesnym stadium zaawansowania, jako komponenta leczenia skojarzonego. Istotną kwestią pozostaje późna toksyczność takiego leczenia. Nowoczesne podejście do radioterapii, które obejmuje zaawan­sowane techniki napromieniania oraz redukcje dawek i obszarów tarczowych, pozwoliło na zmniejszenie wczesnej oraz późnej toksyczności. W ostatnich latach coraz częściej stawiane jest pytanie o konieczność uzupełniającej radioterapii we wczesnych stadiach chłoniaka Hodgkina. Praca ta jest próbą odpowiedzi na to pytanie w świetle ostatnio opublikowanych dowodów naukowych.

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Referencje

  1. Eichenauer DA, Aleman BMP, André M, et al. ESMO Guidelines Committee. Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018; 29(Suppl 4): iv19–iv29.
  2. Engert A, Plütschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med. 2010; 363(7): 640–652.
  3. Eich HT, Diehl V, Görgen H, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol. 2010; 28(27): 4199–4206.
  4. Dörffel W, Rühl U, Lüders H, et al. Treatment of children and adolescents with Hodgkin lymphoma without radiotherapy for patients in complete remission after chemotherapy: final results of the multinational trial GPOH-HD95. J Clin Oncol. 2013; 31(12): 1562–1568.
  5. Wolden SL, Chen Lu, Kelly KM, et al. Long-term results of CCG 5942: a randomized comparison of chemotherapy with and without radiotherapy for children with Hodgkin's lymphoma--a report from the Children's Oncology Group. J Clin Oncol. 2012; 30(26): 3174–3180.
  6. Eichenauer DA, Becker I, Monsef I, et al. Secondary malignant neoplasms, progression-free survival and overall survival in patients treated for Hodgkin lymphoma: a systematic review and meta-analysis of randomized clinical trials. Haematologica. 2017; 102(10): 1748–1757.
  7. Raemaekers JMM, André MPE, Federico M, et al. Omitting radiotherapy in early positron emission tomography-negative stage I/II Hodgkin lymphoma is associated with an increased risk of early relapse: Clinical results of the preplanned interim analysis of the randomized EORTC/LYSA/FIL H10 trial. J Clin Oncol. 2014; 32(12): 1188–1194.
  8. Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-directed therapy for early-stage Hodgkin's lymphoma. N Engl J Med. 2015; 372(17): 1598–1607.
  9. Fuchs M, Goergen H, Kobe C, et al. PET-Guided Treatment of Early-Stage Favorable Hodgkin Lymphoma: Final Results of the International, Randomized Phase 3 Trial HD16 By the German Hodgkin Study Group. Blood. 2018; 132(Supplement 1): 925–925.
  10. Svane IM, Pedersen AE, Johansen JS, et al. Vaccination with p53 peptide-pulsed dendritic cells is associated with disease stabilization in patients with p53 expressing advanced breast cancer; monitoring of serum YKL-40 and IL-6 as response biomarkers. Cancer Immunol Immunother. 2007; 56(9): 1485–1499.
  11. Blank O, von Tresckow B, Monsef I, et al. Chemotherapy alone versus chemotherapy plus radiotherapy for adults with early stage Hodgkin lymphoma. Cochrane Database Syst Rev. 2017; 4: CD007110.
  12. Sher DJ, Mauch PM, Van Den Abbeele A, et al. Prognostic significance of mid- and post-ABVD PET imaging in Hodgkin's lymphoma: the importance of involved-field radiotherapy. Ann Oncol. 2009; 20(11): 1848–1853.
  13. Mikhaeel NG, Hutchings M, Fields PA, et al. Prognostic value of interim FDG-PET after two or three cycles of chemotherapy in Hodgkin lymphoma. Ann Oncol. 2005; 16(7): 1160–1168.
  14. Barnes JA, LaCasce AS, Zukotynski K, et al. End-of-treatment but not interim PET scan predicts outcome in nonbulky limited-stage Hodgkin's lymphoma. Ann Oncol. 2011; 22(4): 910–915.
  15. Kostakoglu L, Schöder H, Johnson JL, et al. Cancer Leukemia Group B. Interim [(18)F]fluorodeoxyglucose positron emission tomography imaging in stage I-II non-bulky Hodgkin lymphoma: would using combined positron emission tomography and computed tomography criteria better predict response than each test alone? Leuk Lymphoma. 2012; 53(11): 2143–2150.
  16. Zinzani PL, Rigacci L, Stefoni V, et al. Early interim 18F-FDG PET in Hodgkin's lymphoma: evaluation on 304 patients. Eur J Nucl Med Mol Imaging. 2012; 39(1): 4–12.
  17. Terasawa T, Lau J, Bardet S, et al. Fluorine-18-fluorodeoxyglucose positron emission tomography for interim response assessment of advanced-stage Hodgkin's lymphoma and diffuse large B-cell lymphoma: a systematic review. J Clin Oncol. 2009; 27(11): 1906–1914.
  18. Gallamini A, Hutchings M, Avigdor A, et al. Early interim PET scan in Hodgkin lymphoma: where do we stand? Leuk Lymphoma. 2008; 49(4): 659–662.
  19. Akhtari M, Milgrom SA, Pinnix CC, et al. Reclassifying patients with early-stage Hodgkin lymphoma based on functional radiographic markers at presentation. Blood. 2018; 131(1): 84–94.
  20. Bonadonna G, Bonfante V, Viviani S, et al. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin's disease: long-term results. J Clin Oncol. 2004; 22(14): 2835–2841.
  21. Engert A, Schiller P, Josting A, et al. German Hodgkin's Lymphoma Study Group. Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol. 2003; 21(19): 3601–3608.
  22. Yahalom J, Illidge T, Specht L, et al. International Lymphoma Radiation Oncology Group, International Lymphoma Radiation Oncology Group, ILROG. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG). Int J Radiat Oncol Biol Phys. 2014; 89(4): 854–862.
  23. Johnson DH, Schiller JH, Bunn PA. Recent clinical advances in lung cancer management. J Clin Oncol. 2014; 32(10): 973–982.