The German Hodgkin Study Group risk model is useful for Hodgkin lymphoma patients receiving radiotherapy after autologous stem cell transplant

C Furlan, F Matrone, M Rupolo, R Ciancia, E Zanet, B Montante, E Palazzari, F Navarria, M Trovo, P Bulian, M Spina, E Coassin, M Mascarin, A De Paoli, G Franchin, M Michieli

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To apply the German Hodgkin Study Group (GHSG) risk model in patients with recurrent/refractory Hodgkin lymphoma receiving involved-field radiotherapy after autologous stem cell transplantation. MATERIAL AND METHODS: The study consisted in the retrospective analysis of 30 consecutive patients with recurrent/refractory Hodgkin lymphoma who received involved-field radiotherapy after autologous stem cell transplantation. Our policy was of adding involved-field radiotherapy for patients with positive PET scan before autologous stem cell transplantation (23 out of 30 patients, 77%), and/or irradiating sites of bulky disease at relapse (11 out of 30 patients, 37%). Patients were stratified into four risk groups according to the presence of the five clinical risk factors identified by the GHSG; (1) stage IV disease; (2) time to relapse≤3 months; (3) ECOG-PS≥1; (4) bulk≥5cm; and (5) inadequate response to salvage chemotherapy. RESULTS: The median interval from autologous stem cell transplantation to involved-field radiotherapy was 3 months (range, 1-7 months), and the median involved-field radiotherapy dose was 35Gy (range, 12-40Gy). At a median follow-up of 35 months (range, 1-132 months), the 2-year progression-free survival in the entire series was 60%. When examining the four different GHSG risk groups, the progression-free survival rate at 2 years was 86%, 83%, 50%, and 36% for patients with score=0, score=1, score=2, and score=3 to 5, respectively (P=0,01). Among the 12 patients havingat leastthree risk factors who underwent thoracic involved-field radiotherapy, three (25%) developed pneumonitis. CONCLUSION: The adoption of the GHSG risk model at the time of recurrence/progression is a useful prognostic tool to select patients with Hodgkin lymphoma for consolidative involved-field radiotherapy after autologous stem cell transplantation.
Original languageEnglish
Pages (from-to)378-384
Number of pages7
JournalCancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique
Volume23
Issue number5
DOIs
Publication statusPublished - Sep 2019

Keywords

  • Greffe
  • Hodgkin lymphoma
  • Lymphome de Hodgkin
  • Radiotherapy
  • Recurrent
  • Transplant
  • radiothérapie
  • recurrence
  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Combined Modality Therapy
  • Female
  • *Hematopoietic Stem Cell Transplantation
  • Hodgkin Disease/diagnostic imaging/*radiotherapy/therapy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • *Models, Theoretical
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Prognosis
  • Progression-Free Survival
  • Radiation Pneumonitis/epidemiology/etiology
  • *Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Assessment/*methods
  • Risk Factors
  • Salvage Therapy
  • Survival Rate
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult

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