Biophysical analysis of the acute toxicity of radiotherapy in Hodgkin's lymphoma--a comparison between extended field and involved field radiotherapy based on the data of the German Hodgkin Study Group.

摘要: Purpose: To determine biophysical parameters from the complication probability data during and after radiotherapy of Hodgkin’s lymphoma (HL), based on number gastrointestinal side effects that were found in multicenter HD8 trial German Hodgkin Lymphoma Study Group. Methods Materials: Between 1993 1998, 1204 patients with newly diagnosed, histology-proven HL clinical Stages I/IIA/IIB defined risk factors stage IIIA without enrolled into study. Patients randomized to receive two cycles COPP (cyclophosphamide, vincristine, procarbazine, prednisone) alternating ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) followed by (RT) 30 Gy extended field plus 10 bulky disease (Arm A) or involved B). For 910 patients, rates acute RT could be determined. Comparison showed differences between Arms A B (Grade 1–2: 16.6 vs. 3.9; Grade 3–4: 0.9 0.2; p 3 ), we determined normal tissue (NTCP) ( V, D, m, n, TD 50 parameter , n (volume dependent) such a manner observed NTCP Arm cases supradiaphragmatic involvement only infradiaphragmatic correlated calculated values. Results: Of 1,204 randomized, 1,064 informative for comparison study arms. The median observation time was 54 months. overall survival all eligible 91%, freedom treatment failure 83%. Survival at 5 years start revealed no terms (85.8% A, 84.2% B) (90.8% 92.4%). There also arms complete remission, progressive disease, relapse, death, secondary neoplasias. In contrast, effects, including leukopenia, thrombocytopenia, nausea, toxicity, pharyngeal more frequent arm. Concerning different radiation volumes resulted NTCPs. On basis these findings, values = 0.09 32 derived. However, this model is sensitive variations parameters. deviation 1% results 10% NTCP. Conclusion Radiotherapy volume reduction COPP/ABVD chemotherapy gives similar less toxicity early-stage, unfavorable HL. Biophysical Because exponential dependence, unstable. It represents “start model” until further can incorporated.