Journal article
Long-Term Outcomes of Patients With Early Stage Nonbulky Hodgkin Lymphoma Treated With Combined Modality Therapy in the Stanford V Trials (the G4 and G5 Studies)
International journal of radiation oncology, biology, physics, Vol.110(2), pp.444-451
06/01/2021
DOI: 10.1016/j.ijrobp.2020.12.039
PMID: 33385495
Abstract
Purpose: Combined modality therapy (CMT) is standard therapy for early-stage Hodgkin lymphoma (ESHL). We previously reported excellent outcomes with the abbreviated Stanford V regimen. Herein we report updated results with median follow-up >10 years on survival, therapy-related late effects, and impact of disease risk factors on patient outcomes.
Methods and Materials: The G4 and G5 studies enrolled patients with stage I-IIA nonbulky ESHL. Patients received 8 weeks of Stanford V chemotherapy followed by 30 Gy modified involved-field radiation therapy (mIFRT) (G4) or Stanford V-C thorn 20 Gy mIFRT (G5). Patients were categorized as favorable or unfavorable risk per German Hodgkin Study Group (GHSG) criteria and outcomes between groups compared.
Results: A total of 129 patients were enrolled (68 favorable and 61 unfavorable risk). In the G4 study (n = 87), at median follow-up of 19.7 years, 5-, 10-, and 15-year progression-free survival (PFS) and overall survival (OS) were 95.4%/97.7%, 91.8%/96.5%, and 91.8%/95.3%, respectively. In the G5 study (n = 42), at median follow-up of 13.5 years, the 5-, 10-, and 15-year PFS and OS were 92.9%/100%, 92.9%/100%, and 88.4%/91.9%, respectively. PFS (P = .86) and OS (P = .86) were not significantly different between studies. There were also no significant differences between studies in patients with favorable or unfavorable risk for PFS (F: P = .53; U: P Z.96), OS (F: P = .99; U: P = .78), secondary malignancies (F: P = .74; U: P Z 1.0), and cardiovascular complications (F: no cases; U: P = 1.0).
Conclusions: The G4 and G5 studies achieve high rates of durable remission; 20 versus 30 Gy mIFRT and cyclophosphamide substituted for mechlorethamine did not compromise nodal control, PFS, or OS in both favorable and unfavorable risk disease. These results support the efficacy of CMT in early-stage disease and lower-dose radiation therapy in patients with favorable and nonbulky unfavorable ESHL. (C) 2020 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Long-Term Outcomes of Patients With Early Stage Nonbulky Hodgkin Lymphoma Treated With Combined Modality Therapy in the Stanford V Trials (the G4 and G5 Studies)
- Creators
- Eric Mou - Stanford UniversityRanjana H. Advani - Stanford UniversityRie von Eyben - Stanford UniversitySaul A. Rosenberg - Stanford UniversityRichard T. Hoppe - Stanford University
- Resource Type
- Journal article
- Publication Details
- International journal of radiation oncology, biology, physics, Vol.110(2), pp.444-451
- Publisher
- Elsevier
- DOI
- 10.1016/j.ijrobp.2020.12.039
- PMID
- 33385495
- ISSN
- 0360-3016
- eISSN
- 1879-355X
- Number of pages
- 8
- Language
- English
- Date published
- 06/01/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359790502771
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