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Role of Consolidative Radiation Therapy After Autologous Hematopoietic Cell Transplantation for the Treatment of Relapsed or Refractory Hodgkin Lymphoma.

Abstract To evaluate the role of the addition of consolidative radiation therapy after high-dose chemotherapy and autologous hematopoietic cell transplantation (AHCT) for relapsed or refractory Hodgkin lymphoma (HL).
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Journal Title international journal of radiation oncology, biology, physics
Publication Year Start




PMID- 28816170
OWN - NLM
STAT- In-Process
DA  - 20170817
LR  - 20170817
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 99
IP  - 1
DP  - 2017 Sep 01
TI  - Role of Consolidative Radiation Therapy After Autologous Hematopoietic Cell
      Transplantation for the Treatment of Relapsed or Refractory Hodgkin Lymphoma.
PG  - 94-102
LID - S0360-3016(17)30904-5 [pii]
LID - 10.1016/j.ijrobp.2017.05.007 [doi]
AB  - PURPOSE: To evaluate the role of the addition of consolidative radiation therapy 
      after high-dose chemotherapy and autologous hematopoietic cell transplantation
      (AHCT) for relapsed or refractory Hodgkin lymphoma (HL). METHODS AND MATERIALS:
      Medical records were reviewed from a total of 80 consecutive patients who
      underwent high-dose chemotherapy with AHCT treated under a single protocol at
      University of Minnesota between November 2005 and January 2014. Of these, 32
      patients received radiation therapy after AHCT as planned consolidation. RESULTS:
      At a median follow-up of 25 months, the 2-year overall survival (OS) and
      progression-free survival (PFS) for the entire cohort was 96% and 52%,
      respectively. Consolidative radiation therapy was found to significantly improve 
      the 2-year PFS (67% vs 42%, P<.01) without a significant change in OS (100% vs
      93%, P=.15). On subgroup analysis, consolidative radiation therapy was shown to
      improve PFS in patients with bulky disease (62% vs 39%, P=.02), B-symptoms (48%
      vs 28%, P=.05), primary refractory disease (47% vs 32%, P=.02), and those with a 
      partial response on pretransplant imaging (47% vs 32%, P=.02). The improvement
      seen on 2-year PFS with consolidative radiation therapy remained significant on
      multivariate analysis (hazard ratio 4.64, 95% confidence interval 1.98-10.88).
      Minimal toxicity was observed among the patients receiving radiation therapy.
      CONCLUSIONS: The addition of consolidative radiation therapy after high-dose
      chemotherapy and AHCT demonstrated a significant improvement in 2-year PFS and no
      impact on OS. Radiation therapy was well tolerated, with minimal toxicity. Our
      study supports a role of consolidative radiation therapy in patients with HL
      treated with AHCT.
CI  - Copyright (c) 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Wilke, Christopher
AU  - Wilke C
AD  - Department of Radiation Oncology, University of Minnesota, Minneapolis,
      Minnesota.
FAU - Cao, Qing
AU  - Cao Q
AD  - Division of Biostatistics, University of Minnesota Medical Center, Minneapolis,
      Minnesota; Blood and Marrow Transplantation Program, University of Minnesota
      Medical Center, Minneapolis, Minnesota.
FAU - Dusenbery, Kathryn E
AU  - Dusenbery KE
AD  - Department of Radiation Oncology, University of Minnesota, Minneapolis,
      Minnesota.
FAU - Bachanova, Veronika
AU  - Bachanova V
AD  - Blood and Marrow Transplantation Program, University of Minnesota Medical Center,
      Minneapolis, Minnesota; Division of Hematology, Oncology, and Transplantation,
      Department of Medicine, University of Minnesota Medical Center, Minneapolis,
      Minnesota.
FAU - Lazaryan, Aleksandr
AU  - Lazaryan A
AD  - Blood and Marrow Transplantation Program, University of Minnesota Medical Center,
      Minneapolis, Minnesota; Division of Hematology, Oncology, and Transplantation,
      Department of Medicine, University of Minnesota Medical Center, Minneapolis,
      Minnesota.
FAU - Lee, Chung K
AU  - Lee CK
AD  - Department of Radiation Oncology, University of Minnesota, Minneapolis,
      Minnesota.
FAU - Yuan, Jianling
AU  - Yuan J
AD  - Department of Radiation Oncology, University of Minnesota, Minneapolis,
      Minnesota. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170515
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
EDAT- 2017/08/18 06:00
MHDA- 2017/08/18 06:00
CRDT- 2017/08/18 06:00
PHST- 2017/02/23 [received]
PHST- 2017/05/01 [revised]
PHST- 2017/05/08 [accepted]
AID - S0360-3016(17)30904-5 [pii]
AID - 10.1016/j.ijrobp.2017.05.007 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2017 Sep 1;99(1):94-102. doi:
      10.1016/j.ijrobp.2017.05.007. Epub 2017 May 15.