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Lymphome de Hodgkin: traitement des stades localisés sus-diaphragmatiques

Treatment of early-stage supradiaphragmatic Hodgkin’s lymphoma

  • Synthèse / Review Article
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Oncologie

Abstract

The risk-adapted therapeutic strategy used for adult patients with Hodgkin’s lymphoma is defined taking into account their risk factors and includes standard first-line ABVD chemotherapy. In early-stage supradiaphragmatic disease, 3 chemotherapeutic courses are applied for patients without risk factors while 4 courses are used for patients with risk factors, followed by a radiation therapy targeting initially involved fields (IFRT) at a dose of 30 Gy. Final analysis of the results of recent trials is expected to determine whether IFRT doses may be reduced to 20 Gy in patients showing chemotherapy-induced complete remission. Chemotherapy alone is not recommended currently, except in ongoing clinical trials in which positron emission tomography (PET) scans are used to evaluate the early response to chemotherapy without radiation. Modern radiation and imaging modalities are expected to permit the restriction of radiation-targeted volumes to initially involved nodes only.

Résumé

Le traitement standard des stades I–II sus-diaphragmatiques est défini selon les facteurs de risque et comporte une chimiothérapie ABVD, trois cycles (patients sans facteur de risque) ou quatre cycles (patients avec facteurs de risque), suivis d’une irradiation des territoires ganglionnaires initialement atteints à la dose de 30 Gy. L’analyse finale des essais récents est attendue pour préciser la possibilité de réduire la dose d’irradiation à 20 Gy après réponse complète induite par la chimiothérapie. Un traitement par chimiothérapie exclusive n’est pas actuellement recommandé, en dehors des essais thérapeutiques en cours qui intègrent la TEP après deux cycles comme élément décisionnel d’un traitement sans radiothérapie. Les techniques modernes d’irradiation et d’imagerie sont développées pour réduire les volumes irradiés aux seuls ganglions initialement atteints.

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Authors and Affiliations

  1. Département de médecine, Institut de cancérologie Gustave-Roussy, 39, rue Camille-Desmoulins, F-94805, Villejuif cedex, France

    C. Fermé

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  1. C. Fermé
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Correspondence to C. Fermé.

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Fermé, C. Lymphome de Hodgkin: traitement des stades localisés sus-diaphragmatiques. Oncologie 10, 303–306 (2008). https://doi.org/10.1007/s10269-008-0836-0

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  • DOI: https://doi.org/10.1007/s10269-008-0836-0

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