{"entity":{"id":"hd10","kind":"trial","name":"GHSG HD10","aka":["HD10","Reduced treatment intensity in early-stage Hodgkin lymphoma"],"tldr":"Halving the chemotherapy and cutting the radiation dose by a third worked just as well for early Hodgkin lymphoma with favourable features, and caused fewer side effects.","summary":"HD10 is the trial that set the modern floor for early favourable Hodgkin lymphoma. 1,370 patients with newly diagnosed early-stage disease and a favourable prognosis were randomly assigned to one of four groups: four cycles of ABVD with 30 Gy of involved-field radiotherapy, four cycles with 20 Gy, two cycles with 30 Gy, or two cycles with 20 Gy. The primary endpoint was freedom from treatment failure.\n\nNeither comparison showed a difference. Five-year freedom from treatment failure was 93.0 per cent (95 per cent confidence interval 90.5 to 94.8) with four cycles and 91.1 per cent (88.3 to 93.2) with two (p = 0.39); overall survival did not differ (p = 0.61). The two radiation doses were also indistinguishable (p = 1.00 for freedom from treatment failure, p = 0.61 for overall survival). Adverse events and acute toxic effects were most common in the group given four cycles and 30 Gy.\n\nTwo cycles of ABVD with 20 Gy became the standard for this group, and the question then moved on: HD16 tested whether the radiotherapy could be dropped altogether when the interim positron emission tomography scan was negative, and found that it could not without losing tumour control.","status":"positive","asOf":"2026-10-01","links":[{"label":"ClinicalTrials.gov NCT00265018","url":"https://clinicaltrials.gov/study/NCT00265018"},{"label":"New England Journal of Medicine 2010","url":"https://doi.org/10.1056/NEJMoa1000067"}],"tags":["lymphoma-evidence"],"related":[],"cancers":["early-stage-classical-hodgkin-lymphoma","hodgkin-lymphoma"],"sections":["chemotherapy","radiation"],"technologies":["radiotherapy","cytotoxic-chemotherapy"],"targets":[],"drugs":["doxorubicin","bleomycin","vinblastine","dacarbazine"],"companies":["ghsg"],"institutions":[],"pathways":[],"terms":["abvd-beacopp"],"trials":["hd16","eortc-h10"],"people":["andreas-engert","peter-borchmann"],"bottlenecks":["b-toxicity-qol","b-survivorship"],"keyPapers":["paper-ghsg-hd10-reduced-intensity-early-hodgkin-nejm-2010"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT00265018","phase":"3","setting":"Early-stage Hodgkin lymphoma with a favourable prognosis: four or two cycles of ABVD, each followed by 30 Gy or 20 Gy of involved-field radiotherapy, in a two by two design","sponsor":"University of Cologne (German Hodgkin Study Group)","result":"Two cycles of ABVD with 20 Gy as effective as four cycles with 30 Gy (five-year freedom from treatment failure 91.1 against 93.0 per cent, p = 0.39) and less toxic.","started":"1998-05","yearReported":2010,"enrolled":1370,"enrolledBasis":"registry","outcomes":[{"endpoint":"Freedom from treatment failure at 5 years","primary":true,"unit":"%","arms":[{"name":"Four cycles of ABVD","value":93,"note":"95 per cent confidence interval 90.5 to 94.8"},{"name":"Two cycles of ABVD","value":91.1,"note":"88.3 to 93.2"}],"p":"0.39","source":"https://doi.org/10.1056/NEJMoa1000067"}],"replication":"The radiation dose finding is consistent with the EORTC H9F experience; the chemotherapy finding set the comparator for HD16 and EORTC H10."},"route":"/trials/hd10/","neighbours":{"cancer":[{"id":"early-stage-classical-hodgkin-lymphoma","kind":"cancer","name":"Early-stage classical Hodgkin lymphoma (stage I to II)","route":"/cancers/early-stage-classical-hodgkin-lymphoma/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"term":[{"id":"abvd-beacopp","kind":"term","name":"ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)","route":"/terms/abvd-beacopp/"},{"id":"radiotherapy","kind":"term","name":"Radiotherapy","route":"/terms/radiotherapy/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"drug":[{"id":"bleomycin","kind":"drug","name":"Bleomycin","route":"/drugs/bleomycin/"},{"id":"dacarbazine","kind":"drug","name":"Dacarbazine","route":"/drugs/dacarbazine/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"vinblastine","kind":"drug","name":"Vinblastine","route":"/drugs/vinblastine/"}],"company":[{"id":"ghsg","kind":"company","name":"German Hodgkin Study Group","route":"/companies/ghsg/"}],"trial":[{"id":"eortc-h10","kind":"trial","name":"EORTC/LYSA/FIL H10","route":"/trials/eortc-h10/"},{"id":"hd16","kind":"trial","name":"GHSG HD16","route":"/trials/hd16/"},{"id":"hd21","kind":"trial","name":"GHSG HD21","route":"/trials/hd21/"}],"person":[{"id":"andreas-engert","kind":"person","name":"Andreas Engert","route":"/people/andreas-engert/"},{"id":"peter-borchmann","kind":"person","name":"Peter Borchmann","route":"/people/peter-borchmann/"}],"bottleneck":[{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-van-nimwegen-cardiovascular-disease-after-hodgkin-jama-intern-med-2015","kind":"paper","name":"Cardiovascular disease after Hodgkin lymphoma treatment: 40-year disease risk","route":"/key-papers/paper-van-nimwegen-cardiovascular-disease-after-hodgkin-jama-intern-med-2015/"},{"id":"paper-ghsg-hd10-reduced-intensity-early-hodgkin-nejm-2010","kind":"paper","name":"GHSG HD10: reduced treatment intensity in early-stage favourable Hodgkin lymphoma","route":"/key-papers/paper-ghsg-hd10-reduced-intensity-early-hodgkin-nejm-2010/"},{"id":"paper-schaapveld-second-cancer-risk-40-years-hodgkin-nejm-2015","kind":"paper","name":"Second cancer risk up to 40 years after treatment for Hodgkin's lymphoma","route":"/key-papers/paper-schaapveld-second-cancer-risk-40-years-hodgkin-nejm-2015/"}],"roadmap":[{"id":"lymphoma-roadmap","kind":"roadmap","name":"Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting","route":"/roadmaps/lymphoma-roadmap/"}]}}