Quality control of involved-field radiotherapy in patients with advanced Hodgkin's lymphoma (EORTC 20884)

Purpose: To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin's lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinblastine (MOPP-ABV) chemotherapy. Methods and Materials: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16-24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose <90% of the prescribed dose. Results: Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. There was no relationship between incidence or site of relapse and major protocol violations. Conclusion: In advanced-stage HL patients in complete remission after six to eight cycles of MOPP-ABV, the outcome was not influenced by violation of the radiotherapy protocol. (c) 2005 Elsevier Inc.

Language

English

Source (journal)

International journal of radiation oncology, biology, physics. - Bedford

Source (book)

23rd Annual Meeting of the, European-Society-for-Therapeutic-Radiology-and-Oncology (ESTRO 23), OCT 24-28, 2004, Amsterdam, NETHERLANDS

Publication

New york : Elsevier science inc , 2005

ISSN

0360-3016

DOI

10.1016/J.IJROBP.2005.03.044