Hodgkins Disease

Consolidation Radiotherapy Could Be Safely Omitted in Advanced Hodgkin Lymphoma With Large Nodal Mass in Complete Metabolic Response After ABVD: Final Analysis of the Randomized GITIL/FIL HD0607 Trial

In the November 20, 2020 edition of Journal of Clinical Oncology, Andrea Gallamini and colleagues report on the results of the Randomized GITIL/FIL HD0607 Trial

PURPOSE

The purpose of the study was to investigate the role of consolidative radiotherapy in patients with Hodgkin’s disease, who had evidence of a nodal mass after completion of chemotherapy with the ABVD regimen.

PATIENTS AND METHODS

Patients with advanced-stage (IIB-IVB) Hodgkin’s lymphoma, enrolled in the HD 0607 trial who had both a negative PET after two (PET-2) and six (PET-6) ABVD cycles, presented at baseline with an lymph node mass, which by definition had largest diameter of at least 5 cm, and were prospectively randomized to receive consolidative radiotherapy or no further treatment.

RESULTS

296 patients were randomized, the largest diameter of lymph node mass at baseline was 5-7 cm in 101 (34%; subgroup A) and 8-10 cm in 96 (32%; subgroup B), while classic bulky masses (diameter > 10 cm) were detected in 99 (33%; subgroup C).  288 patients showed a post chemotherapy treatment residual mass. The median dose of radiotherapy was 30.6 Gy (range, 24-36 Gy). After a median follow-up of 6 years , the 6-year PFS rate for patients who underwent radiotherapy or no further treatment was, respectively, 91% (95% CI, 84% to 99%) and 95% (95% CI, 89% to 100%; P = .62) in subgroup A; 98% (95% CI, 93% to 100%) and 90% (95% CI, 80% to 100%; P = .24) in subgroup B; 89% (95% CI, 81% to 98%) and 86% (95% CI, 77% to 96%; P = .53) in subgroup C (classic bulky).

The authors concluded “ cRT could be safely omitted in patients with HL presenting with an LNM and a negative PET-2 and PET-6 scan, irrespective from the LNM size detected at baseline.”

Reference:

Consolidation Radiotherapy Could Be Safely Omitted in Advanced Hodgkin Lymphoma With Large Nodal Mass in Complete Metabolic Response After ABVD: Final Analysis of the Randomized GITIL/FIL HD0607 Trial

https://ascopubs.org/doi/full/10.1200/JCO.20.00935

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