The Role of Radiation Therapy in Patients With Relapsed or Refractory Hodgkin Lymphoma: Guidelines From the International Lymphoma Radiation Oncology Group.

Autor:	Constine LS; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York; Department of Pediatrics, University of Rochester Medical Center, Rochester, New York. Electronic address: louis_constine@urmc.rochester.edu., Yahalom J; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York., Ng AK; Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts., Hodgson DC; Department of Radiation Oncology, University of Toronto and Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada., Wirth A; Division of Radiation Oncology, Peter MacCallum Cancer Institute, East Melbourne, Australia., Milgrom SA; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas., Mikhaeel NG; Department of Clinical Oncology, Guy's Cancer Centre and King's College London University, London, UK., Eich HT; Department of Radiation Oncology, University of Münster, Münster, Germany., Illidge T; Division of Cancer Sciences, University of Manchester, Manchester Academic Health Sciences Centre, The Christie National Health Service Foundation Trust, Manchester, UK., Ricardi U; Radiation Oncology Unit, Department of Oncology, University of Torino, Torino, Italy., Dieckmann K; Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria., Moskowitz CH; Division of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York., Advani R; Department of Medicine, Division of Medical Oncology, Stanford University, Stanford, California., Mauch PM; Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts; Died September 8, 2017., Specht L; Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Hoppe RT; Department of Radiation Oncology, Stanford University, Stanford, California.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2018 Apr 01; Vol. 100 (5), pp. 1100-1118. Date of Electronic Publication: 2018 Jan 09.
DOI:	10.1016/j.ijrobp.2018.01.011
Abstrakt:	Relapsed and refractory Hodgkin lymphoma (HL) challenges clinicians to devise treatment strategies that are effective and safe. This problem is particularly prominent in an era when de-escalation trials are designed to minimize therapeutic toxicities in both early- and advanced-stage disease. Radiation therapy is the single most effective treatment modality for HL, and its integration into salvage regimens, or its independent use in select patients, must be understood to maximize our success in treating these patients. The complexity of treating relapsed or refractory HL derives from the spectrum of primary treatment approaches currently in use that creates heterogeneity in both treatment exposure and the potential toxicities of salvage therapy. Patients can have relapsed or refractory disease after limited or aggressive primary therapy (with or without radiation therapy), at early or delayed time points, with limited or extensive disease volumes, and with varying degrees of residual morbidity from primary therapy. Their response to salvage systemic therapy can be partial or complete, and the use of consolidative stem cell transplantation is variably applied. New biologics and immunotherapeutic approaches have broadened but also complicated salvage treatment approaches. Through all of this, radiation therapy remains an integral component of treatment for many patients, but it must be used effectively and judiciously. The purpose of this review is to describe the different treatment scenarios and provide guidance for radiation dose, volume, and timing in patients with relapsed or refractory HL. (Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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