GHSG HD10: reduced treatment intensity in early-stage favourable Hodgkin lymphoma
Two cycles of ABVD chemotherapy and a lower radiotherapy dose cured early favourable Hodgkin lymphoma as well as four cycles and a higher dose, so patients could be given less treatment and fewer late effects.
Overview
German Hodgkin Study Group randomised 2 by 2 trial of 1,370 patients with early-stage favourable Hodgkin lymphoma comparing four with two cycles of ABVD and involved-field radiotherapy of 30 Gy with 20 Gy.
Five-year freedom from treatment failure and overall survival were about 93 percent and 97 percent with no differences between arms, while toxicity was lower with the reduced treatment. Two cycles of ABVD followed by 20 Gy became a standard for early favourable disease.
- Five-year freedom from treatment failure about 93 percent and overall survival about 97 percent, with no difference between two and four cycles of ABVD or between 20 and 30 Gy.
- Fewer acute adverse events with the reduced-intensity arm.
Patients with early favourable Hodgkin lymphoma are cured with two cycles of ABVD and 20 Gy of involved-site radiotherapy; later trials tested whether PET can spare radiotherapy altogether.
- Applies only to the GHSG favourable group (no bulk, few nodal areas, normal sedimentation rate, no extranodal disease).
- Predates PET-guided therapy.
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