Evidence map›Paper›PMID 27325479›Full record

ArticleInternational journal of radiation oncology, biology, physics2016

Treatment of Early-Stage Unfavorable Hodgkin Lymphoma: Efficacy and Toxicity of 4 Versus 6 Cycles of ABVD Chemotherapy With Radiation.

Jillian R Gunther, Michelle A Fanale, Jay P Reddy, Mani Akhtari, Grace L Smith, Chelsea C Pinnix, Sarah A Milgrom, Zeinab Abou Yehia, Pamela K Allen, Eleanor M Osborne and 2 more

Abstract read
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In one paragraph

Article in International journal of radiation oncology, biology, physics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jillian R GuntherDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Michelle A FanaleDepartment of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jay P ReddyDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Mani AkhtariDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Galveston, Texas.
Grace L SmithDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Chelsea C PinnixDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Sarah A MilgromDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Zeinab Abou YehiaDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Pamela K AllenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Eleanor M OsborneDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Osama MawlawiDepartment of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Bouthaina S DabajaDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: bdabaja@mdanderson.org.

Funding

Economic Strain and Resilience in Cancer Patients: Assessing Patient-Reported Measures of the Burdens of TreatmentK07CA211804 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SMITH, GRACE · 2016 to 2020
$853k
NCI NIH HHS K07 CA211804
6 · The paper itself

Abstract

purposeThe German Hodgkin Study Group HD11 trial validated 4 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy followed by involved field radiation therapy (IFRT) for early unfavorable Hodgkin lymphoma (HL) patients. However, practitioners often recommend 6 cycles followed by RT, especially for bulky disease. We compared patient outcomes after treatment with 4 or 6 cycles of ABVD followed by RT (IFRT and involved site RT [ISRT]). METHODS AND MATERIALS: We identified 128 patients treated for early unfavorable HL (GHSG criteria) between 2000 and 2013. Clinical outcomes (overall survival [OS] and freedom from relapse [FFR]) were estimated using Kaplan-Meier analysis. Toxicities were evaluated.

resultsThe median follow-up time was 5.0 years. Patients received 4 (70 patients, 55%) or 6 (58 patients, 45%) cycles of chemotherapy. Bulky disease was present in 22 patients (31%; 0 stage IA, 3 stage IB, 19 stage IIA) of the 4-cycle group and 42 patients (72%; 5 stage IA, 3 stage IB, 34 stage IIA) of the 6-cycle group. For patients receiving 4 and 6 cycles, the 6-year OS was 100% and 97% (P=.35), respectively, and the 6 year FFR was 100% and 98% (P=.28), respectively. More patients received 6 cycles if they were treated before 2010 (HD11 report) (P=.01) and if they had bulky disease (P<.01). Sixty-eight percent of patients received ISRT. The 6-year FFR was 99% and 100% for patients receiving ISRT and IFRT, respectively (P=.58). More patients experienced bleomycin pulmonary toxicity in the 6-cycle group (20% vs 31%, P=.16). For patients with bulky disease, the 4-year FFR was similar with receipt of 4 (100%) or 6 (98%) cycles (P=.48) and IFRT (100%) or ISRT (98%) (P=.52). There were no deaths among patients with bulky disease.

conclusionsPatients with early unfavorable HL have excellent outcomes with 4 cycles of ABVD chemotherapy followed by ISRT. Six cycles of chemotherapy does not appear superior for disease control, even for bulky disease.

Indexed as

AdolescentAdultAgedAntineoplastic Combined Chemotherapy ProtocolsBleomycinChemoradiotherapyComorbidityDacarbazineDisease-Free SurvivalDoxorubicinDrug Administration ScheduleFemaleHodgkin DiseaseHumansMaleMiddle AgedBleomycinDacarbazineDoxorubicinVinblastine

Identifiers

PMID27325479
PMCPMC6047754

What OpenQuestion holds

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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.