Long-Term Outcomes in Patients with Early Stage Nodular Lymphocyte-Predominant Hodgkin’s Lymphoma Treated with RadiotherapyReportar como inadecuado




Long-Term Outcomes in Patients with Early Stage Nodular Lymphocyte-Predominant Hodgkin’s Lymphoma Treated with Radiotherapy - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Purpose

Radiation therapy RT is commonly used as definitive treatment for early-stage nodular lymphocyte-predominant Hodgkin’s lymphoma NLPHL. We evaluated the cause-specific survival CSS, overall survival OS, and second malignancy SM rates in patients with early-stage NLPHL treated with RT.

Methods and Materials

Patients with stage I-II NLPHL between 1988 and 2009 who underwent RT were selected from the Surveillance, Epidemiology and End Results database. Univariate analysis UVA for CSS and Os was performed using the Kaplan-Meier method and included age, gender, involved site, year of diagnosis, presence of B-symptoms, and extranodal involvement ENI. Multivariable analysis MVA was performed using Cox Proportional Hazards modeling and included the above clinical variables. SM were classified as RT-related or non-RT-related. Freedom from SM and freedom from RT-related SM were determined using the Kaplan-Meier method.

Results

The study cohort included 469 patients. Median age was 37 years. The most common involved sites were the head and neck 36%, axilla-arm 26%, and multiple lymph node regions 18%. Sixty-eight percent had stage I disease, 70% were male, 4% had ENI, and 7% had B-symptoms. Median follow-up was 6 years. Ten-year CSS and Os were 98% and 88%, respectively. On UVA, none of the covariates was associated with CSS. Increasing age p<0.01 and female gender p<0.01 were associated with worse Os. On MVA, older age p<0.01, female gender p=0.04, multiple regions of involvement p=0.03, stage I disease p=0.02, and presence of B-symptoms p=0.02 were associated with worse Os. Ten-year freedom from SM and freedom from RT-related SM were 89% and 99%, respectively.

Conclusions

This is the largest series to evaluate the outcomes of stage I-II NLPHL patients treated with RT and found that this patient population has an excellent long-term prognosis and a low rate of RT-related second malignancies.



Autor: Abhishek A. Solanki, Melissa Horoschak LeMieux, Brian C.-H. Chiu, Usama Mahmood, Yasmin Hasan, Matthew Koshy

Fuente: http://plos.srce.hr/



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