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dc.contributor.authorDharmarajan, Kavita V.
dc.contributor.authorFriedman, Debra L.
dc.contributor.authorSchwartz, Cindy L.
dc.contributor.authorChen, Lu
dc.contributor.authorFitzGerald, Thomas J.
dc.contributor.authorMcCarten, Kathleen M.
dc.contributor.authorKessel, Sandy K.
dc.contributor.authorIandoli, Matthew
dc.contributor.authorConstine, Louis S.
dc.contributor.authorWolden, Suzanne L.
dc.date2022-08-11T08:10:32.000
dc.date.accessioned2022-08-23T17:12:14Z
dc.date.available2022-08-23T17:12:14Z
dc.date.issued2015-05-01
dc.date.submitted2017-04-07
dc.identifier.citationInt J Radiat Oncol Biol Phys. 2015 May 1;92(1):60-6. doi: 10.1016/j.ijrobp.2014.10.042. Epub 2014 Dec 24. <a href="https://doi.org/10.1016/j.ijrobp.2014.10.042">Link to article on publisher's site</a>
dc.identifier.issn0360-3016 (Linking)
dc.identifier.doi10.1016/j.ijrobp.2014.10.042
dc.identifier.pmid25542311
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46457
dc.description.abstractPURPOSE: The study was designed to determine whether response-based therapy improves outcomes in intermediate-risk Hodgkin lymphoma. We examined patterns of first relapse in the study. PATIENTS AND METHODS: From September 2002 to July 2010, 1712 patients bulk, I-IIAE, I-IIB, and IIIA-IVA with or without doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide were enrolled. Patients were categorized as rapid (RER) or slow early responders (SER) after 2 cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC). The SER patients were randomized to 2 additional ABVE-PC cycles or augmented chemotherapy with 21 Gy involved field radiation therapy (IFRT). RER patients were stipulated to undergo 2 additional ABVE-PC cycles and were then randomized to 21 Gy IFRT or no further treatment if complete response (CR) was achieved. RER without CR patients were non-randomly assigned to 21 Gy IFRT. Relapses were characterized without respect to site (initial, new, or both; and initial bulk or initial nonbulk), and involved field radiation therapy field (in-field, out-of-field, or both). Patients were grouped by treatment assignment (SER; RER/no CR; RER/CR/IFRT; and RER/CR/no IFRT). Summary statistics were reported. RESULTS: At 4-year median follow-up, 244 patients had experienced relapse, 198 of whom were fully evaluable for review. Those who progressed during treatment (n=30) or lacked relapse imaging (n=16) were excluded. The median time to relapse was 12.8 months. Of the 198 evaluable patients, 30% were RER/no CR, 26% were SER, 26% were RER/CR/no IFRT, 16% were RER/CR/IFRT, and 2% remained uncategorized. The 74% and 75% relapses involved initially bulky and nonbulky sites, respectively. First relapses rarely occurred at exclusively new or out-of-field sites. By contrast, relapses usually occurred at nodal sites of initial bulky and nonbulky disease. CONCLUSION: Although response-based therapy has helped define treatment for selected RER patients, it has not improved outcome for SER patients or facilitated refinement of IFRT volumes or doses.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25542311&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395527/
dc.subjectHealth Services Administration
dc.subjectNeoplasms
dc.subjectOncology
dc.subjectPediatrics
dc.subjectRadiology
dc.titlePatterns of relapse from a phase 3 Study of response-based therapy for intermediate-risk Hodgkin lymphoma (AHOD0031): a report from the Children's Oncology Group
dc.typeJournal Article
dc.source.journaltitleInternational journal of radiation oncology, biology, physics
dc.source.volume92
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qarc/11
dc.identifier.contextkey9992201
html.description.abstract<p>PURPOSE: The study was designed to determine whether response-based therapy improves outcomes in intermediate-risk Hodgkin lymphoma. We examined patterns of first relapse in the study.</p> <p>PATIENTS AND METHODS: From September 2002 to July 2010, 1712 patients bulk, I-IIAE, I-IIB, and IIIA-IVA with or without doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide were enrolled. Patients were categorized as rapid (RER) or slow early responders (SER) after 2 cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC). The SER patients were randomized to 2 additional ABVE-PC cycles or augmented chemotherapy with 21 Gy involved field radiation therapy (IFRT). RER patients were stipulated to undergo 2 additional ABVE-PC cycles and were then randomized to 21 Gy IFRT or no further treatment if complete response (CR) was achieved. RER without CR patients were non-randomly assigned to 21 Gy IFRT. Relapses were characterized without respect to site (initial, new, or both; and initial bulk or initial nonbulk), and involved field radiation therapy field (in-field, out-of-field, or both). Patients were grouped by treatment assignment (SER; RER/no CR; RER/CR/IFRT; and RER/CR/no IFRT). Summary statistics were reported.</p> <p>RESULTS: At 4-year median follow-up, 244 patients had experienced relapse, 198 of whom were fully evaluable for review. Those who progressed during treatment (n=30) or lacked relapse imaging (n=16) were excluded. The median time to relapse was 12.8 months. Of the 198 evaluable patients, 30% were RER/no CR, 26% were SER, 26% were RER/CR/no IFRT, 16% were RER/CR/IFRT, and 2% remained uncategorized. The 74% and 75% relapses involved initially bulky and nonbulky sites, respectively. First relapses rarely occurred at exclusively new or out-of-field sites. By contrast, relapses usually occurred at nodal sites of initial bulky and nonbulky disease.</p> <p>CONCLUSION: Although response-based therapy has helped define treatment for selected RER patients, it has not improved outcome for SER patients or facilitated refinement of IFRT volumes or doses.</p>
dc.identifier.submissionpathqarc/11
dc.contributor.departmentDepartment of Radiation Oncology
dc.contributor.departmentQuality Assurance Review Center
dc.source.pages60-6


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