{"entity":{"id":"paper-rapid-pet-directed-therapy-early-hodgkin-nejm-2015","kind":"paper","name":"RAPID: PET-directed therapy for early-stage Hodgkin lymphoma","aka":[],"tldr":"Patients with early Hodgkin lymphoma whose PET scan was clear after three cycles of ABVD did almost as well without radiotherapy as with it, with a small extra risk of relapse but no difference in survival, giving them a choice.","summary":"UK randomised non-inferiority trial of 602 patients with stage IA or IIA non-bulky Hodgkin lymphoma; those with a negative PET after three cycles of ABVD (420 patients) were randomised to involved-field radiotherapy of 30 Gy or no further treatment.\n\nThree-year progression-free survival was 94.6 percent with radiotherapy against 90.8 percent without, which did not meet the pre-specified non-inferiority margin in the intention-to-treat analysis, while overall survival was the same. Omitting radiotherapy trades a few percentage points of relapse for avoiding late radiation effects.","asOf":"2026-09-18","links":[{"label":"N Engl J Med 2015","url":"https://doi.org/10.1056/NEJMoa1408648"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/25901426/"}],"tags":[],"related":[],"cancers":["early-stage-classical-hodgkin-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":["doxorubicin","vinblastine","dacarbazine"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2015,"doi":"10.1056/NEJMoa1408648","pmid":"25901426","authors":"Radford J, Illidge T, Counsell N, et al.","paperType":"rct","findings":["Three-year progression-free survival 94.6 percent with radiotherapy versus 90.8 percent without in PET-negative patients.","No difference in overall survival; non-inferiority was not formally shown."],"whatItMeans":"PET-negative early Hodgkin lymphoma can be treated with chemotherapy alone at a small cost in relapse, an option many younger patients take to avoid radiation to the chest and neck.","caveats":["Relapses after chemotherapy alone are usually salvaged, but require more intensive treatment.","The trial used ABVD alone; the balance may differ with newer regimens."],"changedPractice":true,"participants":602},"route":"/key-papers/paper-rapid-pet-directed-therapy-early-hodgkin-nejm-2015/","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/"}],"drug":[{"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/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}