Radiation no extra help in Hodgkin’s disease

Adding radiotherapy to chemotherapy appears to offer no additional benefits in treatment of certain patients with Hodgkin’s disease, researchers report in the December 1st issue of Blood.

In fact, lead investigator Dr. David J. Straus told Reuters Health “our study found no difference in outcome between patients with non-bulky stages I, II and IIIA Hodgkin’s lymphoma treated with chemotherapy and radiation therapy and those treated with chemotherapy alone.”In particular, Dr. Straus, of Memorial Sloan-Kettering Cancer Center, New York and colleagues compared outcomes in 152 such patients. They were randomized to 6 cycles of doxorubicin, bleomycin, vinblastine and dacarbazine with or without radiotherapy.Complete remission was seen in 94% of the combination group and 6% showed no major response. With chemotherapy alone, 94% showed complete remission, 1.5% had a partial response and the remaining 4.5% had no response.Moreover, at 5 years, there were still no significant differences in outcome.”In view of the long-term toxicities associated with radiation therapy,” Dr. Straus said, “this finding has implications for the care of these patients.”He added that “a national trial employing chemotherapy only for similar patients is in progress.”In an accompanying editorial, Dr. Dan L. Longo of the National Institute on Aging, Bethesda, Maryland points out that in the absence of persuasive data on the efficacy of the combined modality, use of chemotherapy alone “removes the imminent threat posed by radiation exposure for the majority of patients.”(Source: Blood 2004;104:3483-3489,3418: Reuters Health: David Douglas: December 2004.)