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By Alessandro Franciscon doctor
Satish Shanbhag, Richard F Ambinder
Hodgkin lymphoma (HL) is a unique hematopoietic neoplasm characterized by cancerous Reed-Sternberg cells in an inflammatory background. Patients are commonly diagnosed with HL in their 20s and 30s, and they present with supradiaphragmatic lymphadenopathy, often with systemic B symptoms. Even in advanced-stage disease, HL is highly curable with combination chemotherapy, radiation, or combined-modality treatment. Although the same doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapeutic regimen has been the mainstay of therapy over the last 30 years, risk-adapted approaches have helped de-escalate therapy in low-risk patients while intensifying treatment for higher risk patients...
December 1, 2017: CA: a Cancer Journal for Clinicians
Bradford S Hoppe, Richard T Hoppe
PURPOSE: Recently, involved-site radiation therapy (ISRT) guidelines have been developed and published to replace the previous concept of involved-field radiation therapy for patients with lymphoma. However, these ISRT guidelines may be interpreted in different ways, posing difficulties for prospective clinical trials. This study reports survey results regarding interpretation of the ISRT guidelines. METHODS AND MATERIALS: Forty-four expert lymphoma radiation oncologists were asked to participate in a survey that included 7 different cases associated with 9 questions...
May 1, 2015: International Journal of Radiation Oncology, Biology, Physics
M Dreyling, M Ghielmini, S Rule, G Salles, U Vitolo, M Ladetto
No abstract text is available yet for this article.
September 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
J Yahalom, P Mauch
During the last century, the role of radiation therapy in the treatment of Hodgkin's disease (HD) has changed drastically. From a palliative treatment reserved for bulky lymph nodes of an incurable disease at the beginning of the century, to an exciting primary treatment used alone to cure most stages in the 1960s and 1970s, to the present more limited role as consolidation treatment after chemotherapy. Interestingly, the radiation field size has always influenced the evolution of treatment principles of HD...
2002: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Andreas Engert, Heinz Haverkamp, Carsten Kobe, Jana Markova, Christoph Renner, Antony Ho, Josée Zijlstra, Zdenek Král, Michael Fuchs, Michael Hallek, Lothar Kanz, Hartmut Döhner, Bernd Dörken, Nicole Engel, Max Topp, Susanne Klutmann, Holger Amthauer, Andreas Bockisch, Regine Kluge, Clemens Kratochwil, Otmar Schober, Richard Greil, Reinhard Andreesen, Michael Kneba, Michael Pfreundschuh, Harald Stein, Hans Theodor Eich, Rolf-Peter Müller, Markus Dietlein, Peter Borchmann, Volker Diehl
BACKGROUND: The intensity of chemotherapy and need for additional radiotherapy in patients with advanced stage Hodgkin's lymphoma has been unclear. We did a prospective randomised clinical trial comparing two reduced-intensity chemotherapy variants with our previous standard regimen. Chemotherapy was followed by PET-guided radiotherapy. METHODS: In this parallel group, open-label, multicentre, non-inferiority trial (HD15), 2182 patients with newly diagnosed advanced stage Hodgkin's lymphoma aged 18-60 years were randomly assigned to receive either eight cycles of BEACOPP(escalated) (8×B(esc) group), six cycles of BEACOPP(escalated) (6×B(esc) group), or eight cycles of BEACOPP(14) (8×B(14) group)...
May 12, 2012: Lancet
Stephen M Ansell
DISEASE OVERVIEW: Hodgkin lymphoma (HL) is an uncommon B-cell lymphoid malignancy affecting 9,050 new patients annually and representing approximately 11.2% of all lymphomas in the United States. DIAGNOSIS: HL is composed of two distinct disease entities; the more commonly diagnosed classical HL and the rare nodular lymphocyte predominant HL. Nodular sclerosis, mixed cellularity, lymphocyte depletion, and lymphocyte-rich HL are subgroups under the designation of classical HL...
June 2016: American Journal of Hematology
L S Constine, H B Wolkov, J Yahalom, P M Mauch, R L Deming, D E Dosoretz, A J Elman, R T Hoppe, D A Pistenmaa, L R Prosnitz, A Chauvenet, J M Connors, J H Glick, S Leibel
No abstract text is available yet for this article.
June 2000: Radiology
L R Prosnitz, J M Connors, R L Deming, J Yahalom, P M Mauch, L S Constine, D E Dosoretz, A J Elman, R T Hoppe, D A Pistenmaa, H B Wolkov, A Chauvenet, J H Glick, S Leibel
No abstract text is available yet for this article.
June 2000: Radiology
Hans Theodor Eich, Volker Diehl, Helen Görgen, Thomas Pabst, Jana Markova, Jürgen Debus, Anthony Ho, Bernd Dörken, Andreas Rank, Anca-Ligia Grosu, Thomas Wiegel, Johann Hinrich Karstens, Richard Greil, Normann Willich, Heinz Schmidberger, Hartmut Döhner, Peter Borchmann, Hans-Konrad Müller-Hermelink, Rolf-Peter Müller, Andreas Engert
PURPOSE: Combined-modality treatment consisting of four to six cycles of chemotherapy followed by involved-field radiotherapy (IFRT) is the standard of care for patients with early unfavorable Hodgkin's lymphoma (HL). It is unclear whether treatment results can be improved with more intensive chemotherapy and which radiation dose needs to be applied. PATIENTS AND METHODS: Patients age 16 to 75 years with newly diagnosed early unfavorable HL were randomly assigned in a 2 × 2 factorial design to one of the following treatment arms: four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) + 30 Gy of IFRT; four cycles of ABVD + 20 Gy of IFRT; four cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP(baseline)) + 30 Gy of IFRT; or four cycles of BEACOPP(baseline) + 20 Gy of IFRT...
September 20, 2010: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Lena Specht, Joachim Yahalom, Tim Illidge, Anne Kiil Berthelsen, Louis S Constine, Hans Theodor Eich, Theodore Girinsky, Richard T Hoppe, Peter Mauch, N George Mikhaeel, Andrea Ng
Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solely on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques...
July 15, 2014: International Journal of Radiation Oncology, Biology, Physics
Andreas Engert, Annette Plütschow, Hans Theodor Eich, Andreas Lohri, Bernd Dörken, Peter Borchmann, Bernhard Berger, Richard Greil, Kay C Willborn, Martin Wilhelm, Jürgen Debus, Michael J Eble, Martin Sökler, Antony Ho, Andreas Rank, Arnold Ganser, Lorenz Trümper, Carsten Bokemeyer, Hartmut Kirchner, Jörg Schubert, Zdenek Král, Michael Fuchs, Hans-Konrad Müller-Hermelink, Rolf-Peter Müller, Volker Diehl
BACKGROUND: Whether it is possible to reduce the intensity of treatment in early (stage I or II) Hodgkin's lymphoma with a favorable prognosis remains unclear. We therefore conducted a multicenter, randomized trial comparing four treatment groups consisting of a combination chemotherapy regimen of two different intensities followed by involved-field radiation therapy at two different dose levels. METHODS: We randomly assigned 1370 patients with newly diagnosed early-stage Hodgkin's lymphoma with a favorable prognosis to one of four treatment groups: four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by 30 Gy of radiation therapy (group 1), four cycles of ABVD followed by 20 Gy of radiation therapy (group 2), two cycles of ABVD followed by 30 Gy of radiation therapy (group 3), or two cycles of ABVD followed by 20 Gy of radiation therapy (group 4)...
August 12, 2010: New England Journal of Medicine
Rahul R Parikh, Michael L Grossbard, Louis B Harrison, Joachim Yahalom
PURPOSE: The purpose of this study was to compare outcomes with Hodgkin lymphoma (HL) patients receiving IMRT (intensity-modulated radiation therapy), versus those receiving 2D/3D-CRT (3-dimensional conformal RT) in a large observational cohort. PATIENTS AND METHODS: We evaluated patients diagnosed with stage I-IV HL from 1998 to 2011 from the National Cancer Database (NCDB). The association between IMRT use vs. 2D/3D-CRT, co-variables, and outcome was assessed in a Cox proportional hazards model...
January 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Joachim Yahalom, Tim Illidge, Lena Specht, Richard T Hoppe, Ye-Xiong Li, Richard Tsang, Andrew Wirth
Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL, involving any organ in the body and the spectrum of histological sub-types, poses a challenge both for routine clinical care and for the conduct of prospective and retrospective studies. This has led to uncertainty and lack of consistency in RT approaches between centers and clinicians...
May 1, 2015: International Journal of Radiation Oncology, Biology, Physics
Khê Hoang-Xuan, Eric Bessell, Jacoline Bromberg, Andreas F Hottinger, Matthias Preusser, Roberta Rudà, Uwe Schlegel, Tali Siegal, Carole Soussain, Ufuk Abacioglu, Nathalie Cassoux, Martina Deckert, Clemens M F Dirven, Andrés J M Ferreri, Francesc Graus, Roger Henriksson, Ulrich Herrlinger, Martin Taphoorn, Riccardo Soffietti, Michael Weller
The management of primary CNS lymphoma is one of the most controversial topics in neuro-oncology because of the complexity of the disease and the very few controlled studies available. In 2013, the European Association of Neuro-Oncology created a multidisciplinary task force to establish evidence-based guidelines for immunocompetent adults with primary CNS lymphoma. In this Review, we present these guidelines, which provide consensus considerations and recommendations for diagnosis, assessment, staging, and treatment of primary CNS lymphoma...
July 2015: Lancet Oncology
Kimberly S Corbin, Hedy L Kindler, Stanley L Liauw
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors arising in the gastrointestinal tract. Over the last decade, the management and prognosis of GISTs has changed dramatically with molecular characterization of the c-kit mutation and the adoption of targeted systemic therapy. Currently, the standard of care for resectable tumors is surgery, followed by adjuvant imatinib for tumors at high risk for recurrence. Inoperable or metastatic tumors are treated primarily with imatinib. Despite excellent initial response rates, resistance to targeted therapy has emerged as a common clinical problem, with relatively few therapeutic solutions...
2014: OncoTargets and Therapy
Tim Illidge, Lena Specht, Joachim Yahalom, Berthe Aleman, Anne Kiil Berthelsen, Louis Constine, Bouthaina Dabaja, Kavita Dharmarajan, Andrea Ng, Umberto Ricardi, Andrew Wirth
Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era...
May 1, 2014: International Journal of Radiation Oncology, Biology, Physics
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