Consolidation radiotherapy following positron emission tomography complete response in early-stage Hodgkin lymphoma: a meta-analysis

Abstract

Despite a number of randomized trials, there is clinical equipoise whether de-escalation with the omission of radiotherapy (RT) in positron emission tomography (PET) responders is safe in early-stage Hodgkin lymphoma (HL). A comprehensive Medline and conference abstracts search was performed to identify prospective studies with the following criteria: early-stage (stage I/II) HL treated with anthracycline-based chemotherapy with PET-directed randomization to ± consolidation RT. Four studies were meta-analyzed with a total of 2267 patients (RT: n = 1136, no RT: n = 1131). Pooled analysis showed a significant progression-free survival (PFS) benefit with RT (HR = 2.08, 95% CI 1.27– 3.43 p = .004, RE). There was no statistically significant overall survival (OS) benefit with RT for all patients (HR = 0.92, 95% CI 0.37–2.30, p = 0.85), nor in favorable (HR = 0.90, p = .89) or unfavorable risk (HR = 1.01, p = .99). In early-stage PET-negative HL, consolidative RT consistently improves PFS across risk stratifications over PET-directed omission of RT, with no significant impact on OS.

Keywords:

• PET
• Hodgkin lymphoma
• radiotherapy
• early-stage
• meta-analysis

Disclosure statement

J. A. Vargo is Clinical Pathways Chair for Lymphoma Section via Oncology.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.