Nogov´ L et al. (2005) Extended field radiotherapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin's lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG). Ann Oncol 16: 1683–1687

There have been very few clinical studies of patients with early-stage lymphocyte-predominant Hodgkin's lymphoma (LPHL), because of the low incidence of this malignancy. Therefore, to date, no standard treatment has been established; therapeutic options include extended-field (EF) and involved-field (IF) radiotherapy, and combined modality (CM) approaches. In response to this lack of standard treatment, the German Hodgkin Study Group has recently published a retrospective analysis of its response, survival, and toxicity data for different treatment options in patients with stage IA LPHL without risk factors.

Data on 131 patients who had received EF (n=45), IF (n=45), or CM treatment (2–4×ABVD+EF/IF; n=41) were included in this analysis. A complete response (CR) to therapy was achieved by 99% of all patients. CR rates were comparable across all three regimens: 98%, 100%, and 98% for EF, IF, and CM, respectively. After a median follow-up of 43 months for all patients, overall survival and freedom from treatment failure rates were 99% and 95%, respectively. Toxicity was higher in patients who received CM (39% WHO grade 3 and 9.8% WHO grade 4) than in those who underwent EF or IF (2.2% WHO grade 3 only). The authors assert that, based on these data, IF radiotherapy could emerge as the treatment of choice for early stage LPHL, but caution that longer follow-up is required before this therapy can be adopted as standard.