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The Role of Radiation in All Stages of Nodular Lymphocytic Predominant Hodgkin Lymphoma.
Clin Lymphoma Myeloma Leuk 2017; 17(12):819-824CL

Abstract

BACKGROUND

The goal of this study was to assess the survival differences seen in early-stage and advanced-stage nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) based on treatment modality.

PATIENTS AND METHODS

The National Cancer Database was queried to identify patients diagnosed with NLPHL between 2004 and 2012. Overall survival (OS) was determined using univariate and multivariate Cox regression analysis. Kaplan-Meier and log-rank analysis were used to estimate differences in OS between treatment groups.

RESULTS

A total of 1968 patients were identified for analysis, consisting of stage I (40.4%), stage II (29.3%), stage III (22.3%), and stage IV (8.0%) disease. The median age of patients was 46 years. The following factors were predictive of radiotherapy (RT) omission in treatment: increasing age, black race, Medicare insurance, chemotherapy use, stage II to IV disease, and the presence of B-symptoms. On survival analysis, RT was associated with prolonged OS in all stages of NLPHL (50.1 vs. 42.4 months; P < .01). The OS benefit of RT persisted on multivariate analysis (hazard ratio, 0.37; P < .01). On subset analysis, RT was associated with prolonged OS in early disease (49.8 vs. 45.5 months; P < .01), whereas a trend towards an OS benefit was observed in advanced-stage (54.1 vs. 39.6 months; P = .06) NLPHL. Radiotherapy was also associated with prolonged OS among patients with B-symptoms (49.0 vs. 42.6 months; P < .01).

CONCLUSION

The use of RT in NLPHL is less likely among those with advanced-stage disease and B-symptoms. However, we found RT to be associated with prolonged OS in all stages of NLPHL, including those with B-symptoms.

Authors+Show Affiliations

Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT. Electronic address: david.gaffney@hci.utah.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29051078

Citation

Odei, Bismarck, et al. "The Role of Radiation in All Stages of Nodular Lymphocytic Predominant Hodgkin Lymphoma." Clinical Lymphoma, Myeloma & Leukemia, vol. 17, no. 12, 2017, pp. 819-824.
Odei B, Boothe D, Frandsen J, et al. The Role of Radiation in All Stages of Nodular Lymphocytic Predominant Hodgkin Lymphoma. Clin Lymphoma Myeloma Leuk. 2017;17(12):819-824.
Odei, B., Boothe, D., Frandsen, J., Poppe, M. M., & Gaffney, D. K. (2017). The Role of Radiation in All Stages of Nodular Lymphocytic Predominant Hodgkin Lymphoma. Clinical Lymphoma, Myeloma & Leukemia, 17(12), pp. 819-824. doi:10.1016/j.clml.2017.09.013.
Odei B, et al. The Role of Radiation in All Stages of Nodular Lymphocytic Predominant Hodgkin Lymphoma. Clin Lymphoma Myeloma Leuk. 2017;17(12):819-824. PubMed PMID: 29051078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Role of Radiation in All Stages of Nodular Lymphocytic Predominant Hodgkin Lymphoma. AU - Odei,Bismarck, AU - Boothe,Dustin, AU - Frandsen,Jonathan, AU - Poppe,Matthew M, AU - Gaffney,David K, Y1 - 2017/09/23/ PY - 2016/12/08/received PY - 2017/09/07/revised PY - 2017/09/15/accepted PY - 2017/10/21/pubmed PY - 2018/7/10/medline PY - 2017/10/21/entrez KW - Advanced stage KW - B symptoms KW - Definitive KW - Lymphoma KW - Radiation SP - 819 EP - 824 JF - Clinical lymphoma, myeloma & leukemia JO - Clin Lymphoma Myeloma Leuk VL - 17 IS - 12 N2 - BACKGROUND: The goal of this study was to assess the survival differences seen in early-stage and advanced-stage nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) based on treatment modality. PATIENTS AND METHODS: The National Cancer Database was queried to identify patients diagnosed with NLPHL between 2004 and 2012. Overall survival (OS) was determined using univariate and multivariate Cox regression analysis. Kaplan-Meier and log-rank analysis were used to estimate differences in OS between treatment groups. RESULTS: A total of 1968 patients were identified for analysis, consisting of stage I (40.4%), stage II (29.3%), stage III (22.3%), and stage IV (8.0%) disease. The median age of patients was 46 years. The following factors were predictive of radiotherapy (RT) omission in treatment: increasing age, black race, Medicare insurance, chemotherapy use, stage II to IV disease, and the presence of B-symptoms. On survival analysis, RT was associated with prolonged OS in all stages of NLPHL (50.1 vs. 42.4 months; P < .01). The OS benefit of RT persisted on multivariate analysis (hazard ratio, 0.37; P < .01). On subset analysis, RT was associated with prolonged OS in early disease (49.8 vs. 45.5 months; P < .01), whereas a trend towards an OS benefit was observed in advanced-stage (54.1 vs. 39.6 months; P = .06) NLPHL. Radiotherapy was also associated with prolonged OS among patients with B-symptoms (49.0 vs. 42.6 months; P < .01). CONCLUSION: The use of RT in NLPHL is less likely among those with advanced-stage disease and B-symptoms. However, we found RT to be associated with prolonged OS in all stages of NLPHL, including those with B-symptoms. SN - 2152-2669 UR - https://www.unboundmedicine.com/medline/citation/29051078/The_Role_of_Radiation_in_All_Stages_of_Nodular_Lymphocytic_Predominant_Hodgkin_Lymphoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2152-2650(16)30926-0 DB - PRIME DP - Unbound Medicine ER -