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Quality control of involved-field radiotherapy in patients with advanced Hodgkin's lymphoma (EORTC 20884).

By B. Aleman, T. Girinsky, R.W.M. van der Maazen, S.P. Strijk, P. Meijnders, R. Bortolus, M.J. Olofsen-van Acht, M.L. Lybeert, Y. Lievens, H. Eghbali, E.M. Noordijk, R. Tomsic, J.H. Meerwaldt, P.M.P. Poortmans, W.G. Smit, A. Pinna, M. Henry-Amar and J.M.M. Raemaekers


PURPOSE: To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin's lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinblastine (MOPP-ABV) chemotherapy. METHODS AND MATERIALS: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16-24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose <90% of the prescribed dose. RESULTS: Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. There was no relationship between incidence or site of relapse and major protocol violations. CONCLUSION: In advanced-stage HL patients in complete remission after six to eight cycles of MOPP-ABV, the outcome was not influenced by violation of the radiotherapy protocol

Year: 2005
DOI identifier: 10.1016/j.ijrobp.2005.03.044
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Provided by: NARCIS
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