Combination chemoradiotherapy in early Hodgkin lymphoma.

Combination chemoradiotherapy achieves excellent results for the treatment of localized Hodgkin lymphoma. However, late toxic effects occur, mostly related to the radiotherapy administered after the standard adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. The most serious sequelae are radiation-induced secondary cancers. Reducing radiotherapy has not yet prevented late malignancies. However, when radiotherapy was omitted, tumor control was inferior, with more relapses necessitating rescue treatment including high-dose chemotherapy with stem cell support. Early fluorodeoxyglucose positron emission tomography performed after a few cycles of ABVD is evaluated in several randomized trials to identify patients who might be safely treated with chemotherapy alone.