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The Role of Radiotherapy in the Treatment of Malignant Lymphomas – Recommendations of the Czech Lymphoma Study Group


Authors: K. Dědečková 1;  H. Mociková 2;  D. Belada 3;  A. Janíková 4;  M. Dolečková 5;  B. Malinová 6;  D. Feltl 7;  M. Vošmik 8 ;  T. Svoboda 9;  J. Marková 2;  M. Trněný 10
Authors place of work: Ústav radiační onkologie 1. LF UK a Nemocnice Na Bulovce, Praha 1;  Interní hematologická klinika, FN Královské Vinohrady, 3. LF UK, Praha 2;  Interní klinika, FN Hradec Králové 3;  Interní hematoonkologická klinika, FN Brno-Bohunice 4;  Onkologické oddělení, Nemocnice České Budějovice 5;  Radioterapeuticko-onkologické oddělení, FN Motol, Praha 6;  Klinika onkologická, FN Ostrava 7;  Klinika radioterapie a onkologie, FN Hradec Králové 8;  Onkologické a radioterapeutické oddělení, FN Plzeň 9;  I. interní – klinika hematologie, VFN Praha 10
Published in the journal: Klin Onkol 2013; 26(2): 99-109
Category: Original Articles

Summary

Background:
Indication of radiotherapy in lymphoma treatment is an important strategic decision requiring comprehensive expertise. It also calls for a better definition of the position of radiotherapy in clinical practice.

Design:
This position paper represents a consensus between hematooncologists and radiation oncologists on the role of RT in treatment of different histological types and stages of malignant lymphomas. The discussion was underway within professional societies of both specializations (Czech Lymphoma Study Group for the hematooncologists and the Society of Radiation Oncology, Biology and Physics for the radiation oncologists).

Results:
The consensus presented here was reached in early 2012 and draws on evidence-based medicine and clinical practice. Besides defining the role of radiotherapy in lymphoma treatment, this paper also gives specific recommendations on total doses of radiotherapy in lymphoma treatment.

Conclusion:
These recommendations will supplement 7th edition of “Diagnostic and treatment guidelines in patients with malignant lymphoma” scheduled for publication in 2013.

Key words:
radiotherapy – involved field – Hodgkin lymphoma – non-Hodgkin lymphoma – consensus


Zdroje

1. Yahalom J. Radiation therapy in the treatment of lymphoma. Curr Opin Oncol 1999; 11(5): 370–374.

2. Cheson BD, Pfistner B, Juweid ME et al. International Harmonization Project on Lymphoma. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25(5): 579–586.

3. Cheson BD, Horning SJ, Coiffier B et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17(4): 1244.

4. NCCN.org [online]. National Comprehensive Cancer Network, Inc; 2012. NCCN Practice Guidelines in Oncology Hodgkin disease/Lymphoma v.2.2012. [updated 2012 April 3; cit. 2012 May 28]. Available from: http://www.nccn.org/professionals/physician_gls/PDF/hodgkins.pdf.

5. Eichenauer DA, Engert A, Dreyling M. ESMO Guidelines Working Group. Hodgkin’s lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2011; 22 (Suppl 6): 55–58.

6. GHSG.org [online]. [cit. 2012 May 28]. Available from: http://www.ghsg.org/strahlentherapie.

7. Belada D, Trněný M. Diagnostické a léčebné postupy u nemocných s maligními lymfomy. Lymphoma.cz [online]. [citováno 2012 květen 28]. Dostupný z: http://www.lymphoma.cz/docs/KLS-postupy-6.vydani-06-2011-ver2.pdf.

8. Engert A, Schiller P, Josting A et al. German Hodgkin‘s Lymphoma Study Group. Involved field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin‘s lymphoma: results of the HD8 trial of the German Hodgkin‘s Lymphoma Study Group. J Clin Oncol 2003; 21(19): 3601–3608.

9. Engert A, Plütschow A, Eich HT et al. Reduced treatment intensity in patients with early-stage Hodgkin‘s lymphoma. N Engl J Med 2010; 363(7): 640–652.

10. CANCER.gov [online]. [cited 2012 May 28]. Available from: http://www.cancer.gov/cancertopics/pdq/treatment/adulthodgkins/HealthProfessional/page5.

11. Herbst C, Rehan FA, Skoetz N et al. Chemotherapy alone versus chemotherapy plus radiotherapy for early stage Hodgkin lymphoma (Review). The Cochrane Collaboration 2011; 2: CD007110. DOI: 10.1002/14651858.CD007110.pub2.

12. Barnes JA, LaCasce AS, Zukotynski K et al. End-of-treatment but not interim PET scan predicts outcome in nonbulky limited-stage Hodgkin‘s lymphoma. Ann Oncol 2011; 22(4): 910–915.

13. von Tresckow B, Plütschow A, Fuchs M et al. Dose-intensification in early unfavorable Hodgkin‘s Lymphoma: final analysis of the German hodgkin study group HD14 Trial. J Clin Oncol 2012; 30(9): 907–913.

14. Diehl V, Franklin J, Pfreundschuh M et al. German Hodgkin‘s Lymphoma Study Group. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin‘s disease. N Eng J Med 2003; 348(24): 2386–2395.

15. Borchmann P, Haverkamp H, Diehl V et al. Eight cycles of escalated-dose BEACOPP compared with four cycles of escalated-dose BEACOPP followed by four cycles of baseline-dose BEACOPP with or without radiotherapy in patients with advanced-stage hodgkin‘s lymphoma: final analysis of the HD12 trial of the German Hodgkin Study Group. J Clin Oncol 2011; 29(32): 4234–4242.

16. Engert A, Haverkamp H, Kobe C et al. German Hodgkin Study Group; Swiss Group for Clinical Cancer Research; Arbeitsgemeinschaft Medikamentöse Tumortherapie. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin‘s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet 2012; 379(9828): 1791–1799. doi: 10.1016/S0140-6736(11)61940-5.

17. Nogová L, Reineke T, Eich HT et al. Extended field radio­therapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin‘s lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG). Ann Oncol 2005; 16(10): 1683–1687.

18. Eichenauer DA, Fuchs M, Pluetschow A et al. Phase 2 study of Rituximabin newly diagnosed stage IA nodular lymphocyte-predominant Hodgkin lymphoma:a report from the German Hodgkin Study Group Blood 2011; 118(16): 4363–4365.

19. Nogová L, Reineke T, Brillant C et al. German Hodgkin Study Group. Lymphocyte-predominant and classical Hodgkin’s lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol 2008; 26(3): 434–439.

20. Josting A, Nogová L, Franklin J et al. Salvage radiotherapy in patients with relapsed and refractory Hodgkin’s lymphoma: a retrospective analysis from the German Hodgkin Lymphoma Study Group. J Clin Oncol 2005; 23(7): 1522–1529.

21. Josting A, Rudolph C, Mapara M et al. Cologne high-dose sequential chemotherapy in relapsed and refractory Hodgkin lymphoma: results of a large multicenter study of the German Hodgkin Lymphoma Study Group (GHSG). Ann Oncol 2005; 16(1): 116–123.

22. Josting A, Müller H, Borchmann P et al. Dose intensity of chemotherapy in patients with relapsed Hodgkin‘s lymphoma. J Clin Oncol 2010; 28(34): 5074–5080.

23. Moskowitz CH, Nimer SD, Zelentz AD et al. A 2-step comprehensive high-dose chemoradiotherapy second-line program for relapsed and refractory Hodgkin disease: analysis by intent to treat and development of a prognostic model. Blood 2001; 97(3): 616–623.

24. Moskowitz CH, Yahalom J, Zelenetz AD et al. High-dose chemo-radiotherapy for relapsed or refractory Hodgkin lymphoma and the significance of pre-transplant functional imaging. Br J Haematol 2010; 148(6): 890–897.

25. Morschhauser F, Brice P, Fermé C et al. GELA//SFGM Study Group. Risk-adapted salvage treatment with single or tandem autologous stem-cell transplantation for first relapse/refractory Hodgkin‘s lymphoma: results of the prospective multicenter H96 trial by the GELA/SFGM study group. J Clin Oncol 2008; 26(36): 5980–5987.

26. Fermé C, Eghbali H, Meerwaldt JH et al. EORTC-GELA H8 Trial. Chemotherapy plus involved-field radiation in early-stage Hodgkin‘s disease. N Eng J Med 2007; 357(19): 1916–1927.

27. Engert A, Franklin J, Eich HT. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin‘s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol 2007; 25(23): 3495–3502.

28. Hoelzer D, Gökbuget N. T-cell lymphoblastic lymphoma and T-cell acute lymphoblastic leukemia: a separate entity? Clin Lymphoma Myeloma 2009; 9 (Suppl 3): S214–S221.

29. Cortelazzo S, Ponzoni M, Ferreri AJ et al. Lymphoblastic lymphoma. Crit Rev Oncol Hematol 2011; 79(3): 330–343.

30. Portell CA, Sweetenham JW. Adult lymphoblastic lymphoma. Cancer J 2012; 18(5): 432–438.

31. Blum KA, Lozanski G, Byrd JC. Adult Burkitt leukemia and lymphoma. Blood 2004; 104(10): 3009–3020.

32. Bekelman JE, Yahalom J. Quality of radiotherapy reporting in randomized controlled trials of Hodgkin‘s lymphoma and non-Hodgkin‘s lymphoma: a systematic review. Int J Radiat Oncol Biol Phys 2009; 73(2): 492–498.

33. Ng KA, Mauch PM. Role of radiation therapy in localized aggressive lymphoma. J Clinic Oncol 2007; 25(7): 757–759.

34. Travis LB, Curtis RE, Glimelius B. Second cancers among long-term survivors of non-Hodgkin‘s lymphoma. J Natl Cancer Inst 1993; 85(23): 1932–1937.

35. Horning SJ, Weller E, Kim KM et al. Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin‘s lymphoma: Eastern Cooperative Oncology Group study 1484. J Clin Oncol 2004; 22(15): 3032–3038.

36. Reyes F, Lepage E, Ganem G et al. ACVBP versus CHOP plus radiotherapy for localized aggressive lymphoma. N Engl J Med 2005; 352(12): 1197–1205.

37. Miller TP, Dahlberg S, Cassady JR et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin‘s lymphoma. N Engl J Med 1998; 339(1): 21–26.

38. Bonnet C, Fillet G, Mounier N et al. Groupe d‘Etude des Lymphomes de l‘Adulte. CHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Groupe d‘Etude des Lymphomes de l‘Adulte. J Clin Oncol 2007; 25(7): 787–792.

39. Phan J, Mazloom A, Medeiros JL. Benefit of consolidative radiation therapy in patients with diffuse large B-cell lymphoma treated with R-CHOP chemotherapy. J Clin Oncol 2010; 28(27): 4170–4176.

40. Vitolo U, Ferreri AJ, Zucca E. Primary testicular lymphoma. Crit Rev Oncol Hematol 2008; 65(2): 183–189.

41. Koukourakis G, Kouloulias V. Lymphoma of the testis as primary location: tumour review. Clin Transl Oncol 2010; 12(5): 321–325.

42. Avilés A, Delgado S, Nambo MJ et al. Adjuvant radiotherapy to sites of previous bulky disease in patients stage IV diffuse large cell lymphoma. Intl J Rad Oncol Biol Phys 1994; 30(4): 799–803.

43. Avilés A, Fernándezb R, Perez F et al. Adjuvant radiotherapy in stage IV diffuse large cell lymphoma improves outcome. Leuk Lymphoma 2004; 45(7): 1385–1389.

44. Ferreri AJ, Dell‘Oro S, Reni M et al. Consolidation radio­therapy to bulky or semibulky lesions in the management of stage III–IV diffuse large B cell lymphomas. Oncol 2000; 58(3): 219–226.

45. Ziepert M, Reiser M, Poeschel V et al. The role of radiotherapy to bulky disease in the rituximab era: Results of two prospective trials of the German High-Grade Non-Hodgkin-Lymphoma Study Group (DSHNHL) for elderly patients with DLBCL. Blood 2008; 112: 219, abstract 584.

46. Schlembach PJ, Wilder RB, Tucker SL et al. Impact of involved field radiotherapy after CHOP-based chemotherapy on stage III–IV, intermediate grade and large-cell immunoblastic lymphomas. Intl J Rad Oncol Biol Phys 2000; 48(4): 1107–1110.

47. Dorth JA, Broadwater G, Prosnitz LR et al. Impact of consolidative radiation therapy in stage III–IV diffuse large B-cell lymphoma. Int J Rad Oncol Biol Phys (Proceedings of ASTRO) 2010; 78: 552.

48. Dorth JA, Prosnitz LR, Broadwater G et al. Impact of consolidation radiation therapy in stage III–IV diffuse large B-cell lymphoma with negative post-chemotherapy radiologic imaging. Intl J Rad Oncol Biol Phys 2012; 84(3): 762–767.

49. Kelsey CR, Baven AW, Diehl LF et al. Radiation therapy in the management of diffuse large B-cell lymphoma: still relevant? Oncol 2010; 24(13): 1204–1212.

50. Kahn ST, Flowers CR, Lechowicz MJ et al. Refractory or relapsed Hodgkin‘s disease and non-Hodgkin‘s lymphoma: optimizing involved-field radiotherapy in transplant patients. Cancer J 2005; 11(5): 425–431.

51. DeAngelis LM, Seiferheld W, Schold SC et al. Radiation Therapy Oncology Group Study 93-10. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol 2002; 20(24): 4643–4648.

52. Shah, GD, Yahalom J, Correa DD et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 2007; 25(30): 4730–4735.

53. Ferreri AJ, Reni M, Foppoli M et al. International Extranodal Lymphoma Study Group (IELSG). High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet 2009; 374(9700): 1512–1520.

54. Reni M, Ferreri AJ, Garancini MP et al. Therapeutic management of primary central nervous lymphoma in immunocompetent patients: results of a critical review of the literature. Ann Oncol 1997; 8(3): 227–234.

55. Huang MJ, Jiang Y, Liu WP et al. Early or up-front radio­therapy improved survival of localized extranodal NK/-cell lymphoma, nasal-type in the upper aerodigestive tract. Int J Rad Oncol Biol Phys 2008; 70(1): 166–174.

56. Jones GW, Kacinski BM, Wilson LD et al. Total skin elektron radiation in management mycosis fungoides: Consensus of European Organisation for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Project Group. J Am Acad Dermatos 2002; 47(3): 364–370.

57. Hoppe RT. Mycosis fungoides: radiation therapy. Dermatol Ther 2003; 16(4): 347–354.

58. Jones GW, Hoppe RT, Glatstein E. Electron beam treatment for cutaneous T-cell lymphoma. Hematol Oncol Clin North Am 1995; 9(5): 1058–1073.

59. Navi D, Riaz N, Levin YS et al. The Stanford University experience with conventional-dose, total skin electron-beam therapy in the treatment of generalized patch or plaque (T2) and tumor (T3) mycosis fungoides. Arch Dermatol 2011; 147(5): 561–567.

60. Jones G, Wilson LD, Fox-Goguen L. Total skin electron beam radiotherapy for patiens who have mycosis fungoides. Hematol Oncol Clin North Am 2003; 17(6): 1421–1443.

61. Duvic M, Donato M, Dabaja B et al. Total skin electron beam and non-myeloablative allogeneic hematopoietic stem-cell transplantation in advanced mycosis fungoides and Sezary syndrome. J Clin Oncol 2010; 28(14): 2365–2372.

62. Hoppe RT, Cox RS, Fuks Z et al. Electron-beam therapy for mycosis fungoides: The Stanford University experience. Cancer Treat Rep 1979; 63(4): 691–700.

63. Pugh TJ, Ballonoff A, Newman F. Improved survival in patients with early stage low-grade follicular lymphoma treated with radiation: a Surveillance, Epidemiology, and End Results Database Analysis. Cancer 2010; 116(16): 3843–3851.

64. Ha CS, Kong JS, Tucker SL et al. Central lymphatic irradiation for stage I–III follicular lymphoma: report from a single-institutional prospective study. Int J Radiat Oncol Biol Phys 2003; 57(2): 316–320.

65. Ha CS, Tucker SL, Blanco AI et al. Salvage central lymphatic irradiation in follicular lymphomas following failure of chemotherapy: a feasibility study. Int J Radiat Oncol Biol Phys 1999; 45(5): 1207–1212.

66. NCCN.org [online]. National Comprehensive Cancer Network, Inc; 2012. NCCN Practice Guidelines in Oncology non-Hodgkin‘s lymphoma v.3.2012. [updated 2012 September 7]. Available from: http://www.nccn.org/professionals/physician_gls/pdf/nhl.pdf.

Štítky
Paediatric clinical oncology Surgery Clinical oncology

Článok vyšiel v časopise

Clinical Oncology

Číslo 2

2013 Číslo 2
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