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Long-term outcomes in patients with early stage nodular lymphocyte-predominant Hodgkin's lymphoma treated with radiotherapy.
PLoS One 2013; 8(9):e75336Plos

Abstract

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.

Authors+Show Affiliations

Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois, United States of America.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

24058675

Citation

Solanki, Abhishek A., et al. "Long-term Outcomes in Patients With Early Stage Nodular Lymphocyte-predominant Hodgkin's Lymphoma Treated With Radiotherapy." PloS One, vol. 8, no. 9, 2013, pp. e75336.
Solanki AA, LeMieux MH, Chiu BC, et al. Long-term outcomes in patients with early stage nodular lymphocyte-predominant Hodgkin's lymphoma treated with radiotherapy. PLoS ONE. 2013;8(9):e75336.
Solanki, A. A., LeMieux, M. H., Chiu, B. C., Mahmood, U., Hasan, Y., & Koshy, M. (2013). Long-term outcomes in patients with early stage nodular lymphocyte-predominant Hodgkin's lymphoma treated with radiotherapy. PloS One, 8(9), pp. e75336. doi:10.1371/journal.pone.0075336.
Solanki AA, et al. Long-term Outcomes in Patients With Early Stage Nodular Lymphocyte-predominant Hodgkin's Lymphoma Treated With Radiotherapy. PLoS ONE. 2013;8(9):e75336. PubMed PMID: 24058675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes in patients with early stage nodular lymphocyte-predominant Hodgkin's lymphoma treated with radiotherapy. AU - Solanki,Abhishek A, AU - LeMieux,Melissa Horoschak, AU - Chiu,Brian C-H, AU - Mahmood,Usama, AU - Hasan,Yasmin, AU - Koshy,Matthew, Y1 - 2013/09/18/ PY - 2013/05/20/received PY - 2013/08/12/accepted PY - 2013/9/24/entrez PY - 2013/9/24/pubmed PY - 2014/10/1/medline SP - e75336 EP - e75336 JF - PloS one JO - PLoS ONE VL - 8 IS - 9 N2 - 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24058675/Long_term_outcomes_in_patients_with_early_stage_nodular_lymphocyte_predominant_Hodgkin's_lymphoma_treated_with_radiotherapy_ L2 - http://dx.plos.org/10.1371/journal.pone.0075336 DB - PRIME DP - Unbound Medicine ER -