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Evidence summaries

Chemotherapy Alone Versus Chemotherapy Plus Radiotherapy for Early Stage Hodgkin Lymphoma

Adding radiotherapy to chemotherapy improves 5-year overall survival and tumour control in patients with newly diagnosed Hodgkin's lymphoma compared to chemotherapy alone. There is no evidence that complete response rate is different between the treatment groups. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included included five RCTs with a total of 1245 patients comparing chemotherapy alone with chemotherapy plus radiotherapy (combined modality treatment = CMT) in patients with early stage Hodgkin lymphoma.

Patients with a newly confirmed diagnosis of clinical stage (CS) I and II or pathologic stage (PS) I and II Hodgkin's lymphoma and without previous treatment were included. Overall survival (OS) and tumour control was significantly better in the CMT group (HR 0.40; 95% CI 0.27 to 0.61 and 0.41; 95% CI 0.25 to 0.66, respectively) compared to chemotherapy alone. Complete response rates were similar between treatment groups (RR 1.07; 95% CI 0.98 to 1.17).

Clinical comments

As most of the trials had a median observation time of less than 10 years, long term data on secondary malignancies cannot be expected.

Note

Date of latest search:

References

  • Herbst C, Rehan FA, Skoetz N et al. Chemotherapy alone versus chemotherapy plus radiotherapy for early stage Hodgkin lymphoma. Cochrane Database Syst Rev 2011;(2):CD007110. [PubMed]

Primary/Secondary Keywords