Treatment plan improves survival for Hodgkin lymphoma patients
16 December 2011
A Canadian-led clinical trial has found that patients with limited stage Hodgkin lymphoma have better overall survival rates when treated with chemotherapy compared with those receiving extensive radiation. The results were presented at the American Society of Hematology annual meeting and published online by The New England Journal of Medicine.
Currently, patients with limited stage Hodgkin lymphoma receive radiation therapy combined with chemotherapy. While this combination therapy is effective at controlling the disease, patients may experience long-term side effects, such as heart conditions or subsequent cancers, from the radiation.
For this study, the researchers recruited 405 patients with limited stage (IA or IIA) Hodgkin lymphoma (HL). The trial participants were divided into favourable- and unfavourable-risk groups and randomized into two treatment arms: those who received the ABVD chemotherapy regimen and those who received radiation therapy (with or without chemotherapy). The trial began in 1994 and final analysis of the data has now been performed.
At the 12-year mark, the researchers found that participants treated with chemotherapy had an overall survival rate of 94 per cent while those also treated with radiation therapy had an overall survival rate of 87 per cent. This is despite observing that patients treated with radiation therapy had a better freedom from disease progression – that is control of the Hodgkin lymphoma with initial therapy – than those who were treated with chemotherapy alone. The reason for improved survival in those treated with chemotherapy alone is because there were fewer deaths from causes other than Hodgkin lymphoma. The researchers note that current radiation treatment practices include less extensive radiation than studied in this trial, but concluded that these results will direct current practices.
Dr Michael Wosnick, Vice-President Research, Canadian Cancer Society, and Scientific Director, Canadian Cancer Society Research Institute, says: “Clinical trials are the only way to answer these important treatment questions. In this instance, the trial has identified a more effective treatment for limited-stage Hodgkin lymphoma patients which helps to preserve their quality of life. The Canadian Cancer Society is proud to be a key supporter of this kind of research.”
The researchers conclude that the results of their study show that patients with limited-stage Hodgkin lymphoma can benefit from a treatment plan that uses chemotherapy without radiation. The findings will help doctors and patients make more informed treatment decisions and better balance the benefits and risk.
According to the Canadian Cancer Statistics, in 2011 an estimated 920 Canadians will be diagnosed with Hodgkin lymphoma and 130 will die of it. Hodgkin lymphoma is a form of cancer that disproportionally affects younger people. In this clinical trial, the median age of subjects at the time of diagnosis was 35 years.
The study was led by the NCIC Clinical Trials Group (NCIC CTG), which is funded by the Canadian Cancer Society. The NCIC CTG is a cancer clinical trials cooperative group that conducts phase I-III trials testing anti-cancer and supportive therapies across Canada and internationally. The NCIC CTG’s Central Office is located at Queen’s University in Kingston, Ontario.
The Canadian Cancer Society is a national community-based organization of volunteers whose mission is the eradication of cancer and the enhancement of the quality of life of people living with cancer. When you want to know more about cancer, visit our website www.cancer.ca or call our toll-free, bilingual Cancer Information Service at 1 888 939-3333.