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Positronenemissionstomographie gestützte Behandlung des Morbus Hodgkin im frühen günstigen Stadium: Endergebnisse der Deutschen Hodgkin Studiengruppe (DHSG)

Authors: Dr. med. Bernd Frerker, Prof. Dr. med. Guido Hildebrandt

Published in: Strahlentherapie und Onkologie | Issue 5/2020

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Die kombinierte Therapiemodalität (CMT) mit 2 Zyklen ABVD (Adriamycin [Doxorubicin], Bleomycin, Vinblastin und Dacarbazin) und mit konsolidierender Involved-field-Radiotherapie (IF-RT) stellt den aktuellen Therapiestandard des Hodgkin-Lymphoms im frühen günstigen Stadium dar. Dennoch wird die Rolle der Strahlentherapie in diesem Lymphomstadium immer wieder infrage gestellt. Eine Positronenemissionstomographie nach 2 Zyklen ABVD (Interim-PET, PET-2) könnte helfen, individuell das Therapieergebnis vorherzusagen und damit einen risikoadaptierten Behandlungsweg zu ermöglichen. …

Fuchs M, Goergen H, Kobe C, Kuhnert G, Lohri A et al (2019) HD16 – positron emission tomography-guided treatment in early-stage favorable Hodgkin Lymphoma: final results of the international, randomized phase III HD16 trial by the German Hodgkin study group. HD16 trial. J Clin Oncol 37:2835–2845. https://doi.org/10.1200/JCO.19.00964 CrossRefPubMed

Dühmke E, Franklin J, Pfreundschuh M, Sehlen S, Willich N et al (2001) HD04 – Low-dose radiation is sufficient for the noninvolved extended-field treatment in favorable early-stage Hodgkin’s disease: long-term results of a randomized trial of radiotherapy alone. HD04 trial. J Clin Oncol 19:2905–2914. https://doi.org/10.1200/JCO.2001.19.11.2905 CrossRefPubMed

Engert A, Franklin J, Eich HT, Brillant C, Sehlen S et al (2007) HD07 – Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. HD07 trial. J Clin Oncol 25:3495–3502. https://doi.org/10.1200/JCO.2006.07.0482 CrossRefPubMed

Engert A, Plütschow A, Eich HT, Lohri A, Dörken B et al (2010) HD10 – Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. HD10 tri. N Engl J Med 363:640–652. https://doi.org/10.1056/NEJMoa1000067 CrossRefPubMed

Specht L, Gray RG, Clarke MJ, Peto R (1998) Influence of more extensive radiotherapy and adjuvant chemotherapy on long-term outcome of early-stage Hodgkin’s disease: a meta-analysis of 23 randomized trials involving 3,888 patients. International Hodgkin’s Disease Collaborative Group. J Clin Oncol 16:830–843. https://doi.org/10.1200/JCO.1998.16.3.830 CrossRefPubMed

Engert A, Schiller P, Josting A, Herrmann R, Koch P et al (2003) HD08 – 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. HD08-trial. J Clin Oncol 21:3601–3608. https://doi.org/10.1200/JCO.2003.03.023 CrossRefPubMed

Noordijk EM, Carde P, Dupouy N, Hagenbeek A, Krol ADG et al (2006) H7F – Combined-modality therapy for clinical stage I or II Hodgkin’s lymphoma: long-term results of the European Organisation for Research and Treatment of Cancer H7 randomized controlled trials. H7F-trial. J Clin Oncol 24:3128–3135. https://doi.org/10.1200/JCO.2005.05.2746 CrossRefPubMed

Behringer K, Goergen H, Hitz F, Zijlstra JM, Greil R et al (2015) HD13 – Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin’s lymphoma (GHSG HD13): an open-label, randomised, non-inferiority trial. HD13 trial. Lancet 385:1418–1427. https://doi.org/10.1016/S0140-6736(14)61469-0 CrossRefPubMed

Hutchings M, Loft A, Hansen M, Pedersen LM, Buhl T et al (2006) FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 107:52–59. https://doi.org/10.1182/blood-2005-06-2252 CrossRefPubMed

10.

Bednaruk-Młyński E, Pieńkowska J, Skórzak A, Małkowski B, Kulikowski W et al (2015) Comparison of positron emission tomography/computed tomography with classical contrast-enhanced computed tomography in the initial staging of Hodgkin lymphoma. Leuk Lymphoma 56:377–382. https://doi.org/10.3109/10428194.2014.919635 CrossRefPubMed

11.

Leitlinienprogramm Onkologie (2019) S3-Leitlinie – Diagnostik, Therapie und Nachsorge des Hodgkin Lymphoms bei erwachsenen Patienten. Empfehlung 3.14: PET zum Staging, S.44. Version 2.1. AWMF-Registernummer: 018/029 2019. https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Hodgkin/Version_2/LL_Hodgkin-Lymphom_Langversion_2.1.pdf. Zugegriffen: 24.12.2019

12.

Gallamini A, Rigacci L, Merli F, Nassi L, Bosi A et al (2006) The predictive value of positron emission tomography scanning performed after two courses of standard therapy on treatment outcome in advanced stage Hodgkin’s disease. Haematologica 91:475–481PubMed

13.

Rigacci L, Puccini B, Zinzani PL, Biggi A, Castagnoli A et al (2015) The prognostic value of positron emission tomography performed after two courses (INTERIM-PET) of standard therapy on treatment outcome in early stage Hodgkin lymphoma: a multicentric study by the fondazione italiana linfomi (FIL). Am J Hematol 90:499–503. https://doi.org/10.1002/ajh.23994 CrossRefPubMed

14.

Spaepen K, Stroobants S, Dupont P, Thomas J, Vandenberghe P et al (2001) Can positron emission tomography with (18)F-fluorodeoxyglucose after first-line treatment distinguish Hodgkin’s disease patients who need additional therapy from others in whom additional therapy would mean avoidable toxicity? Br J Haematol 115:272–278. https://doi.org/10.1046/j.1365-2141.2001.03169.x CrossRefPubMed

15.

Engert A, Haverkamp H, Kobe C, Markova J, Renner C et al (2012) HD15 – Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin’s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. HD15-trial. Lancet 379:1791–1799. https://doi.org/10.1016/S0140-6736(11)61940-5 CrossRefPubMed

16.

Borchmann P, Goergen H, Kobe C, Lohri A, Greil R et al (2018) HD18 – PET-guided treatment in patients with advanced-stage Hodgkin’s lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group. HD18-trial. Lancet 390:2790–2802. https://doi.org/10.1016/S0140-6736(17)32134-7 CrossRefPubMed

17.

Radford J, Illidge T, Counsell N, Hancock B, Pettengell R et al (2015) RAPID – results of a trial of PET-directed therapy for early-stage Hodgkin’s lymphoma. RADIP-trial. N Engl J Med 372:1598–1607. https://doi.org/10.1056/NEJMoa1408648 CrossRefPubMed

18.

André MPE, Girinsky T, Federico M, Reman O, Fortpied C et al (2017) H10 – early positron emission tomography response-adapted treatment in stage I and II hodgkin lymphoma: final results of the randomized EORTC/LYSA/FIL H10 trial. H10-trial. J Clin Oncol 35:1786–1794. https://doi.org/10.1200/JCO.2016.68.6394 CrossRefPubMed

19.

Leitlinienprogramm Onkologie (2019) S3-Leitlinie – Diagnostik, Therapie und Nachsorge des Hodgkin Lymphoms bei erwachsenen Patienten. Empfehlung 5.6: PET nach 2 Zyklen ABVD im frühen Stadium, S. 52 f. Version 2.1. AWMF-Registernummer: 018/029. https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Hodgkin/Version_2/LL_Hodgkin-Lymphom_Langversion_2.1.pdf. Zugegriffen: 24.12.2019

20.

Laskar S, Gupta T, Vimal S, Muckaden MA, Saikia TK et al (2004) Consolidation radiation after complete remission in Hodgkin’s disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need? J Clin Oncol 22:62–68. https://doi.org/10.1200/JCO.2004.01.021 CrossRefPubMed

21.

Nachman JB, Sposto R, Herzog P, Gilchrist GS, Wolden SL et al (2002) Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 20:3765–3771. https://doi.org/10.1200/JCO.2002.12.007 CrossRefPubMed

22.

Canellos GP (2005) Chemotherapy alone for early Hodgkin’s lymphoma: an emerging option. J Clin Oncol 23:4574–4576. https://doi.org/10.1200/JCO.2005.01.911 CrossRefPubMed

23.

Specht L, Yahalom J, Illidge T, Berthelsen AK, Constine LS et al (2014) Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG). Int J Radiat Oncol Biol Phys 89:854–862. https://doi.org/10.1016/j.ijrobp.2013.05.005 CrossRefPubMed

24.

Murray L, Sethugavalar B, Robertshaw H, Bayman E, Thomas E et al (2015) Involved node, site, field and residual volume radiotherapy for Lymphoma: a comparison of organ at risk dosimetry and second malignancy risks. Clin Oncol 27:401–410. https://doi.org/10.1016/j.clon.2015.03.005 CrossRef

Title: Positronenemissionstomographie gestützte Behandlung des Morbus Hodgkin im frühen günstigen Stadium: Endergebnisse der Deutschen Hodgkin Studiengruppe (DHSG)
Authors: Dr. med. Bernd Frerker
Prof. Dr. med. Guido Hildebrandt
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 5/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01600-4

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