Evidence map›Paper›PMID 21328291›Full record

SynthesisThe Cochrane database of systematic reviews2011

Chemotherapy alone versus chemotherapy plus radiotherapy for early stage Hodgkin lymphoma.

Christine Herbst, Fareed Ahmed Rehan, Nicole Skoetz, Julia Bohlius, Corinne Brillant, Holger Schulz, Ina Monsef, Lena Specht, Andreas Engert

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 6 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Pooled it
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  7. Trial
  8. Pharmacokinetics of dacarbazine (DTIC) in pregnancy.Cancer chemotherapy and pharmacology · 2018
    Article
  9. ACR Appropriateness Criteria® Recurrent Hodgkin Lymphoma.Oncology (Williston Park, N.Y.) · 2016
    Review
  10. Article
  11. Review
  12. Review
  13. Review
  14. Review
  15. Article
  16. Review
  17. Role of modern radiation therapy in early stage Hodgkin's lymphoma: A young radiation oncologists' perspective.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2012
    Review
  18. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 3 countries.

Christine HerbstOberstr 116, Cologne, Germany, 51149.
Fareed Ahmed Rehan
Nicole Skoetz
Julia Bohlius
Corinne Brillant
Holger Schulz
Ina Monsef
Lena Specht
Andreas Engert
University Hospital Cologne · DERigshospitalet · DKUniversity of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCombined modality treatment (CMT) consisting of chemotherapy followed by localised radiotherapy is standard treatment for patients with early stage Hodgkin lymphoma (HL). However, due to long term adverse effects such as secondary malignancies, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication.

objectivesWe performed a systematic review with meta-analysis of randomised controlled trials (RCTs) comparing chemotherapy alone with CMT in patients with early stage Hodgkin lymphoma with respect to response rate, progression-free survival (alternatively tumour control) and overall survival (OS). SEARCH STRATEGY: We searched MEDLINE, EMBASE and CENTRAL as well as conference proceedings from January 1980 to November 2010 for randomised controlled trials comparing chemotherapy alone to the same chemotherapy regimen plus radiotherapy. SELECTION CRITERIA: Randomised controlled trials comparing chemotherapy alone with CMT in patients with early stage HL. Trials in which the chemotherapy differed between treatment arms were excluded. Trials with more than 20% of patients in advanced stage were also excluded. DATA COLLECTION AND ANALYSIS: Effect measures used were hazard ratios (HR) for tumour control and OS as well as relative risks for response rates. Two review authors independently extracted data and assessed quality of trials. We contacted study authors to obtain missing information. Since none of the trials reported progression-free survival according to our definitions, all similar outcomes were evaluated as tumour control. MAIN

resultsFive RCTs involving 1245 patients were included. The HR was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumour control and 0.40 (95% CI 0.27 to 0.61) for OS for patients receiving CMT compared to chemotherapy alone. Complete response rates were similar between treatment groups. In sensitivity analyses another six trials were included that did not fulfil the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. AUTHORS'

conclusionsAdding radiotherapy to chemotherapy improves tumour control and overall survival in patients with early stage Hodgkin lymphoma.

Indexed as

Combined Modality TherapyHodgkin DiseaseHumansRandomized Controlled Trials as TopicSurvival Analysis

Identifiers

PMID21328291
OpenAlexW2026863359

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.