Radiation Therapy for Hodgkin Lymphoma and Other Hematopoietic Disorders

Part of the Medical Radiology book series (MEDRAD)


Hematologic malignancies involve the blood, bone marrow or lymph nodes including Hodgkin’s Lymphoma, Non-Hodgkin’s Lymphoma, Myeloma, and Leukemias. Extensive research over the past two decades has led to an explosion of new therapies resulting in improvement in outcomes. Radiation therapy continues to play a paramount role in the therapy of many hematologic malignancies, whether as definitive therapy, as consolidation after chemotherapy, as part of bone marrow transplantation protocols, or as palliation. During the past two decades, significant advances in radiation therapy have occurred, including the development of involved-node radiation therapy and the adoption of conformal radiation administration. It is expected that modern techniques will reduce the long-term sequelae associated with radiation-based treatments. This review will discuss the current role of radiation therapy, focusing especially on Hodgkin’s Lymphoma and to a lesser extent on Non-Hodgkin’s Lymphoma and plasmacytoma.


Positron Emission Tomography Planning Target Volume Intensity Modulate Radiation Therapy Clinical Target Volume Combine Modality Therapy 


  1. Aleman BM, Raemaekers JM, Tirelli U et al (2003a) Involved-field radiation therapy for advanced Hodgkin’s lymphoma. N Engl J Med 348(24):2396–2406PubMedCrossRefGoogle Scholar
  2. Aleman BM, van den Belt-Dusebout AW, Klokman WJ, Van’t Veer MB, Bartelink H, van Leeuwen FE (2003b) Long-term cause-specific mortality of patients treated for Hodgkin’s disease. J Clin Oncol 21(18):3431–3439PubMedCrossRefGoogle Scholar
  3. Aleman BM, Raemaekers JM, Tomisic R et al (2007) Involved-field radiation therapy for patients in partial remission after chemotherapy for advanced Hodgkin’s lymphoma. Int J Radiat Oncol Biol Phys 67(1):19–30PubMedCrossRefGoogle Scholar
  4. Altman DG, Royston P (2000) What do we mean by validating a prognostic model? Stat Med 19(4):453–473PubMedCrossRefGoogle Scholar
  5. Anagnostopoulos I, Hansmann ML, Franssila K et al (2000) European task force on lymphoma project on lymphocyte predominance Hodgkin disease: Histologic and immunohistologic analysis of submitted cases reveals 2 types of Hodgkin disease with a nodular growth pattern and abundant lymphocytes. Blood 96(5):1889–1899PubMedGoogle Scholar
  6. Ashton-Key M, Thorpe PA, Allen JP, Isaacson PG (1995) Follicular Hodgkin’s disease. Am J Surg Pathol 19(11):1294–1299PubMedCrossRefGoogle Scholar
  7. Backstrand KH, Ng AK, Takvorian RW et al (2001) Results of a prospective trial of mantle irradiation alone for selected patients with early-stage Hodgkin’s disease. J Clin Oncol 19(3):736–741PubMedGoogle Scholar
  8. Ballova V, Ruffer JU, Haverkamp H et al (2005) A prospectively randomized trial carried out by the German Hodgkin Study Group (GHSG) for elderly patients with advanced Hodgkin’s disease comparing BEACOPP baseline and COPP-ABVD (study HD9elderly). Ann Oncol 16(1):124–131PubMedCrossRefGoogle Scholar
  9. Bangerter M, Moog F, Buchmann I et al (1998) Whole-body 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) for accurate staging of Hodgkin’s disease. Ann Oncol 9(10):1117–1122PubMedCrossRefGoogle Scholar
  10. Barrington SF, Qian W, Somer EJ et al (2010) Concordance between four European centres of PET reporting criteria designed for use in multicentre trials in Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 37(10):1824–1833PubMedCrossRefGoogle Scholar
  11. Belkacémi Y, Zouhair A, Ozsahin M et al (2006) Prognostic factors and management of rare cancers. Cancer Radiother 10:323–329PubMedCrossRefGoogle Scholar
  12. Bernstein SH, Burack WR (2009) The incidence, natural history, biology, and treatment of transformed lymphomas. Hematology Am Soc Hematol Educ Program 532–541Google Scholar
  13. Birdwell SH, Hancock SL, Varghese A, Cox RS, Hoppe RT (1997) Gastrointestinal cancer after treatment of Hodgkin’s disease. Int J Radiat Oncol Biol Phys 37(1):67–73PubMedCrossRefGoogle Scholar
  14. Biti GP, Cimino G, Cartoni C et al (1992) Extended-field radiation therapy is superior to MOPP chemotherapy for the treatment of pathologic stage I-IIA Hodgkin’s disease: eight-year update of an Italian prospective randomized study. J Clin Oncol 10(3):378–382PubMedGoogle Scholar
  15. Boleti E, Johnson PW (2007) Primary mediastinal B-cell lymphoma. Hematol Oncol 25:157–163PubMedCrossRefGoogle Scholar
  16. Bonadonna G, Bonfante V, Viviani S, Di Russo A, Villani F, Valagussa P (2004) ABVD plus subtotal nodal versus involved-field radiation therapy in early-stage Hodgkin’s disease: long-term results. J Clin Oncol 22(14):2835–2841PubMedCrossRefGoogle Scholar
  17. Buchmann I, Reinhardt M, Elsner K et al (2001) 2-(fluorine-18)fluoro-2-deoxy-d-glucose positron emission tomography in the detection and staging of malignant lymphoma. A bicenter trial. Cancer 91(5):889–899PubMedCrossRefGoogle Scholar
  18. Burke HB, Henson DE (1993) The American joint committee on cancer. Criteria for prognostic factors and for an enhanced prognostic system. Cancer 72(10):3131–3135PubMedCrossRefGoogle Scholar
  19. Campbell B, Wirth A, Milner A, Di Iulio J, MacManus M, Ryan G (2005) Long-term follow-up of salvage radiation therapy in Hodgkin’s lymphoma after chemotherapy failure. Int J Radiat Oncol Biol Phys 63(5):1538–1545PubMedCrossRefGoogle Scholar
  20. Campbell BA, Voss N, Pickles T et al (2008) Involved-nodal radiation therapy as a component of combination therapy for limited-stage Hodgkin’s lymphoma: a question of field size. J Clin Oncol 26(32):5170–5174PubMedCrossRefGoogle Scholar
  21. Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M (1971) Report of the committee on Hodgkin’s disease staging classification. Cancer Res 31(11):1860–1861PubMedGoogle Scholar
  22. Carde P, Hagenbeek A, Hayat M et al (1993) Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage Hodgkin’s disease: the H6 twin randomized trials from the European organization for research and treatment of cancer lymphoma cooperative group. J Clin Oncol 11(11):2258–2272PubMedGoogle Scholar
  23. Carmel RJ, Kaplan HS (1976) Mantle irradiation in Hodgkin’s disease. An analysis of technique, tumor eradication, and complications. Cancer 37(6):2813–2825PubMedCrossRefGoogle Scholar
  24. Cheson BD, Horning SJ, Coiffier B et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI sponsored international working group. J Clin Oncol 17(4):1244PubMedGoogle Scholar
  25. Cheson BD, Pfistner B, Juweid ME et al (2007) Revised response criteria for malignant lymphoma. J Clin Oncol 25(5):579–586PubMedCrossRefGoogle Scholar
  26. Coia LR, Hanks GE (1988) Complications from large field intermediate dose infradiaphragmatic radiation: an analysis of the patterns of care outcome studies for Hodgkin’s disease and seminoma. Int J Radiat Oncol Biol Phys 15(1):29–35PubMedCrossRefGoogle Scholar
  27. Cosset JM, Henry-Amar M, Meerwaldt JH (1991) Long-term toxicity of early stages of Hodgkin’s disease therapy: the EORTC experience. EORTC lymphoma cooperative group. Ann Oncol 2(Suppl 2):77–82PubMedCrossRefGoogle Scholar
  28. De Bruin ML, Dorresteijn LD, van’t Veer MB et al (2009a) Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma. J Natl Cancer Inst 101(13):928–937PubMedCrossRefGoogle Scholar
  29. De Bruin ML, Sparidans J, van’t Veer MB et al (2009b) Breast cancer risk in female survivors of Hodgkin’s lymphoma: lower risk after smaller radiation volumes. J Clin Oncol 27(26):4239–4246PubMedCrossRefGoogle Scholar
  30. de Wit M, Bohuslavizki KH, Buchert R, Bumann D, Clausen M, Hossfeld DK (2001) 18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin’s lymphoma. Ann Oncol 12(1):29–37PubMedCrossRefGoogle Scholar
  31. Diehl V, Loeffler M, Pfreundschuh M et al (1995) Further chemotherapy versus low-dose involved-field radiation therapy as consolidation of complete remission after six cycles of alternating chemotherapy in patients with advance Hodgkin’s disease. German Hodgkins’ Study Group (GHSG). Ann Oncol 6(9):901–910PubMedGoogle Scholar
  32. Diehl V, Sextro M, Franklin J et al (1999) Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin’s disease and lymphocyte-rich classical Hodgkin’s disease: report from the European task force on lymphoma project on lymphocyte-predominant Hodgkin’s disease. J Clin Oncol 17(3):776–783PubMedGoogle Scholar
  33. Diehl V, Haverkamp H, Mueller RP et al (2008) Eight cycles of BEACOPP escalated compared with 4 cycles of BEACOPP escalated followed by 4 cycles of BEACOPP baseline with or without radiation therapy in patients in advanced stage Hodgkin lymphoma (HL): final analysis of the randomised HD12 trial of the German Hodgkin Study Group (GHSG). Blood 112:(11) [Abstract 1558]Google Scholar
  34. Diller L, Medeiros Nancarrow C, Shaffer K et al (2002) Breast cancer screening in women previously treated for Hodgkin’s disease: a prospective cohort study. J Clin Oncol 20(8):2085–2091PubMedCrossRefGoogle Scholar
  35. Dimopoulos MA, Moulopoulos A, Delasalle K et al (1992) Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Hematol Oncol Clin North Am 6:359–369PubMedGoogle Scholar
  36. Donaldson SS, Link MP (1987) Combined modality treatment with low-dose radiation and MOPP chemotherapy for children with Hodgkin’s disease. J Clin Oncol 5(5):742–749PubMedGoogle Scholar
  37. Duhmke E, Diehl V, Loeffler M et al (1996) Randomized trial with early-stage Hodgkin’s disease testing 30 Gy vs. 40 Gy extended field radiation therapy alone. Int J Radiat Oncol Biol Phys 36(2):305–310PubMedCrossRefGoogle Scholar
  38. Eich HT, Müller RP, Engenhart-Cabillic R, Lukas P, Schmidberger H et al (2008) Involved-node radiation therapy in early-stage Hodgkin’s lymphoma. Definition and guidelines of the German Hodgkin Study Group (GHSG). Strahlenther Onkol 184(8):406–410PubMedCrossRefGoogle Scholar
  39. Eich HT, Diehl V, Gorgen H et al (2010) Intensified chemotherapy and dose-reduced involved-field radiation therapy in patients with early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol 28(27):4199–4206PubMedCrossRefGoogle Scholar
  40. Elstrom R, Guan L, Baker G et al (2003) Utility of FDG-PET scanning in lymphoma by WHO classification. Blood 101(10):3875–3876PubMedCrossRefGoogle Scholar
  41. Emami B, Lyman J, Brown A et al (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21(1):109–122PubMedCrossRefGoogle Scholar
  42. Engert A, Schiller P, Josting A et al (2003) Involved-field radiation therapy is equally effective and less toxic compared with extended-field radiation therapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin’s lymphoma: results of the HD8 trial of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 21(19):3601–3608PubMedCrossRefGoogle Scholar
  43. Engert A, Franklin J, Eich HT et al (2007) Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiation therapy is superior to radiation therapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol 25(23):3495–3502PubMedCrossRefGoogle Scholar
  44. Engert A, Diehl V, Franklin J et al (2009) Escalated-dose BEACOPP in the treatment of patients with advanced stage Hodgkin’s lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol 27(27):4548–4554PubMedCrossRefGoogle Scholar
  45. Engert A, Plutschow A, Eich HT et al (2010) Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med 363(7):640–652PubMedCrossRefGoogle Scholar
  46. Fabian CJ, Mansfield CM, Dahlberg S et al (1994) Low-dose involved field radiation after chemotherapy in advanced Hodgkin disease. A southwest oncology group randomized study. Ann Intern Med 120(11):903–912PubMedGoogle Scholar
  47. Ferme C, Mounier N, Casasnovas O et al (2006) Long-term results and competing risk analysis of the H89 trial in patients with advanced stage Hodgkin lymphoma: a study by the Groupe d’Etude des Lymphomes de l’Adulte (GELA). Blood 107(12):4636–4642PubMedCrossRefGoogle Scholar
  48. Ferme C, Eghbali H, Meerwaldt JH et al (2007) Chemotherapy plus involved-field radiation in early-stage Hodgkin’s disease. N Engl J Med 357(19):1916–1927PubMedCrossRefGoogle Scholar
  49. Fletcher GH, Shukovsky LJ (1975) The interplay of radiocurability and tolerance in the irradiation of human cancers. J Radiol Electrol Med Nucl 56(5):383–400PubMedGoogle Scholar
  50. Franklin J, Pluetschow A, Paus M et al (2006) Second malignancy risk associated with treatment of Hodgkin’s lymphoma: meta-analysis of the randomised trials. Ann Oncol 17(12):1749–1760PubMedCrossRefGoogle Scholar
  51. Franklin J, Paus M, Pluetschow A, Specht L (2009) Chemotherapy, radiation therapy and combined modality for Hodgkin’s disease, with emphasis on second cancer risk. Wiley, New YorkGoogle Scholar
  52. Frassica DA, Frassica FJ, Schray MF et al (1989) Solitary plasmacytoma of bone: Mayo Clinic experience. Int J Radiat Oncol Biol Phys 16:43–48PubMedCrossRefGoogle Scholar
  53. Friedberg JW, Fischman A, Neuberg D et al (2004) FDG-PET is superior to gallium scintigraphy in staging and more sensitive in the follow-up of patients with de novo Hodgkin lymphoma: a blinded comparison. Leuk Lymphoma 45(1):85–92PubMedCrossRefGoogle Scholar
  54. Front D, Israel O (1995) The role of Ga-67 scintigraphy in evaluating the results of therapy of lymphoma patients. Semin Nucl Med 25(1):60–71PubMedCrossRefGoogle Scholar
  55. Gale RP, Butturini A, Bortin MM (1991) What does total body irradiation do in bone marrow transplants for leukemia? Int J Radiat Oncol Biol Phys 20:631–634PubMedCrossRefGoogle Scholar
  56. Gallamini A, Hutchings M, Rigacci L et al (2007) Early interim 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography is prognostically superior to international prognostic score in advanced stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 25(24):3746–3752PubMedCrossRefGoogle Scholar
  57. Gilbert R (1925) La roentgentherapie de la granulomatose maligne. J Radiol Electrol 9:509–514Google Scholar
  58. Gilbert R (1939) Radiation therapy in Hodgkin’s disease (malignant granulomatosis). Am J Roentgenol 41:198–241Google Scholar
  59. Gilbert R, Babaiantz L (1931) Notre Methode De Roentgentherapie De La Lymphogranulomatoses (Hodgkin): Resultats Eloignes. Acta Radiol 12:523–529CrossRefGoogle Scholar
  60. Ginzton EL, Mallory KB, Kaplan HS (1957) The Stanford medical linear accelerator. I. Design and development. Stanford Med Bull 15(3):123–140PubMedGoogle Scholar
  61. Girinsky T, van der Maazen R, Specht L et al (2006) Involved-node radiation therapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol 79(3):270–277PubMedCrossRefGoogle Scholar
  62. Girinsky T, Specht L, Ghalibafian M et al (2008) The conundrum of Hodgkin lymphoma nodes: to be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines. Radiother Oncol 88(2):202–210PubMedCrossRefGoogle Scholar
  63. Glanzmann C, Kaufmann P, Jenni R, Hess OM, Huguenin P (1998) Cardiac risk after mediastinal irradiation for Hodgkin’s disease. Radiother Oncol 46(1):51–62PubMedCrossRefGoogle Scholar
  64. Goodman KA, Toner S, Hunt M, Wu EJ, Yahalom J (2005) Intensity-modulated radiation therapy for lymphoma involving the mediastinum. Int J Radiat Oncol Biol Phys 62(1):198–206PubMedCrossRefGoogle Scholar
  65. Gospodarowicz MK, Henson DE, Hutter RVP, O’Sullivan B, Sobin LH, Wittekind C (2001) Prognostic Factors in Cancer, 2nd edn. Wiley-Liss, New YorkGoogle Scholar
  66. Haas RL, Poortmans P, de Jong D et al (2003) High response rates and lasting remissions after low-dose involved field radiation therapy in indolent lymphomas. J Clin Oncol 21:2474–2480PubMedCrossRefGoogle Scholar
  67. Haas RL, Poortmans P, de Jong D et al (2005) Effective palliation by low dose local radiation therapy for recurrent and/or chemotherapy refractory non-follicular lymphoma patients. Eur J Cancer 41:1724–1730PubMedCrossRefGoogle Scholar
  68. Haas RL, Girinsky T, Aleman BM et al (2009) Low-dose involved-field radiation therapy as alternative treatment of nodular lymphocyte predominance Hodgkin’s lymphoma. Int J Radiat Oncol Biol Phys 74:1199–1202PubMedCrossRefGoogle Scholar
  69. Haioun C, Lepage E, Gisselbrecht C et al (2000) Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin’s lymphoma: final analysis of the prospective LNH87–2 protocol–a groupe d’Etude des lymphomes de l’Adulte study. J Clin Oncol 18(16):3025–3030PubMedGoogle Scholar
  70. Hancock SL, Hoppe RT (1996) Long-term complications of treatment and causes of mortality after Hodgkin’s disease. Semin Radiat Oncol 6(3):225–242PubMedCrossRefGoogle Scholar
  71. Hancock SL, Tucker MA, Hoppe RT (1993) Factors affecting late mortality from heart disease after treatment of Hodgkin’s disease. JAMA 270(16):1949–1955PubMedCrossRefGoogle Scholar
  72. Hanks GE, Kinzie JJ, White RL, Herring DF, Kramer S (1983) Patterns of care outcome studies. Results of the national practice in Hodgkin’s disease. Cancer 51(4):569–573PubMedCrossRefGoogle Scholar
  73. Harris NL, Jaffe ES, Stein H et al (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84(5):1361–1392PubMedGoogle Scholar
  74. Harris NL, Jaffe ES, Diebold J et al (1999) World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the clinical advisory committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 17(12):3835–3849PubMedGoogle Scholar
  75. Haybittle JL, Hayhoe FG, Easterling MJ et al (1985) Review of British National lymphoma investigation studies of Hodgkin’s disease and development of prognostic index. Lancet 1(8435):967–972PubMedCrossRefGoogle Scholar
  76. Henry-Amar M, Friedman S, Hayat M et al (1991) Erythrocyte sedimentation rate predicts early relapse and survival in early-stage Hodgkin disease. The EORTC lymphoma cooperative group. Ann Intern Med 114(5):361–365PubMedGoogle Scholar
  77. Herbst C, Rehan FA, Brillant C et al (2010) Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin’s lymphoma: a systematic review. Haematologica 95(3):494–500PubMedCrossRefGoogle Scholar
  78. Hodgson DC, Koh ES, Tran TH et al (2007) Individualized estimates of second cancer risks after contemporary radiation therapy for Hodgkin lymphoma. Cancer 110(11):2576–2586PubMedCrossRefGoogle Scholar
  79. Hoppe RT (ed) (1993) Hodgkin’s Disease: Patterns of care study newsletter, 1990–1991. American College of Radiology, PhiladelphiaGoogle Scholar
  80. Hoppe RT, Coleman CN, Cox RS, Rosenberg SA, Kaplan HS (1982) The management of stage I–II Hodgkin’s disease with irradiation alone or combined modality therapy: the Stanford experience. Blood 59(3):455–465PubMedGoogle Scholar
  81. Horning SJ, Hoppe RT, Hancock SL, Rosenberg SA (1988) Vinblastine, bleomycin, and methotrexate: an effective adjuvant in favorable Hodgkin’s disease. J Clin Oncol 6(12):1822–1831PubMedGoogle Scholar
  82. Horning SJ, Hoppe RT, Breslin S, Bartlett NL, Brown BW, Rosenberg SA (2002) Stanford V and radiation therapy for locally extensive and advanced Hodgkin’s disease: mature results of a prospective clinical trial. J Clin Oncol 20(3):630–637PubMedCrossRefGoogle Scholar
  83. Hueltenschmidt B, Sautter-Bihl ML, Lang O et al (2001) Whole body positron emission tomography in the treatment of Hodgkin disease. Cancer 91(2):302–310PubMedCrossRefGoogle Scholar
  84. Hutchings M, Barrington SF (2009) PET/CT for therapy response assessment in lymphoma. J Nucl Med 50(Suppl 1):21S–30SPubMedCrossRefGoogle Scholar
  85. Hutchings M, Eigtved AI, Specht L (2004) FDG-PET in the clinical management of Hodgkin lymphoma. Crit Rev Oncol Hematol 52(1):19–32PubMedCrossRefGoogle Scholar
  86. Hutchings M, Loft A, Hansen M et al (2006) FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 107(1):52–59PubMedCrossRefGoogle Scholar
  87. Ifrah N, Hunault M, Jais JP et al (1996) Infradiaphragmatic Hodgkin’s disease: long term results of combined modality therapy. Leuk Lymphoma 21(1–2):79–84PubMedCrossRefGoogle Scholar
  88. Isasi CR, Lu P, Blaufox MD (2005) A meta-analysis of 18F–2-deoxy-2-fluoro-d-glucose positron emission tomography in the staging and restaging of patients with lymphoma. Cancer 104(5):1066–1074PubMedCrossRefGoogle Scholar
  89. Itti E, Lin C, Dupuis J et al (2009) Prognostic value of interim 18F-FDG PET in patients with diffuse large B-Cell lymphoma: SUV-based assessment at 4 cycles of chemotherapy. J Nucl Med 50(4):527–533PubMedCrossRefGoogle Scholar
  90. Jackson H, Parker F (1944a) Hodgkin’s Disease II. Pathology. N Engl J Med 231:35–44Google Scholar
  91. Jackson H, Parker F (1944b) Hodgkin’s Disease I. General considerations. N Engl J Med 230:1–8CrossRefGoogle Scholar
  92. Jerusalem G, Warland V, Najjar F et al (1999a) Whole-body 18F-FDG PET for the evaluation of patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. Nucl Med Commun 20(1):13–20PubMedCrossRefGoogle Scholar
  93. Jerusalem G, Beguin Y, Fassotte MF et al (1999b) Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 94(2):429–433PubMedGoogle Scholar
  94. Jerusalem G, Beguin Y, Fassotte MF et al (2003) Early detection of relapse by whole-body positron emission tomography in the follow-up of patients with Hodgkin’s disease. Ann Oncol 14(1):123–130PubMedCrossRefGoogle Scholar
  95. Johnson PW, Sydes MR, Hancock BW, Cullen M, Radford JA, Stenning SP (2010) Consolidation radiation therapy in patients with advanced Hodgkin’s lymphoma: survival data from the UKLG LY09 randomized controlled trial (ISRCTN97144519). J Clin Oncol 28(20):3352–3359PubMedCrossRefGoogle Scholar
  96. Josting A, Nogova L, Franklin J et al (2005) Salvage radiation therapy in patients with relapsed and refractory Hodgkin’s lymphoma: a retrospective analysis from the German Hodgkin lymphoma study group. J Clin Oncol 23(7):1522–1529PubMedCrossRefGoogle Scholar
  97. Kaplan HS (1962) The radical radiation therapy of regionally localized Hodgkin’s disease. Radiol 78:553–561Google Scholar
  98. Kelly KM, Hutchinson RJ, Sposto R et al (2002) Feasibility of upfront dose-intensive chemotherapy in children with advanced stage Hodgkin’s lymphoma: preliminary results from the Children’s Cancer Group Study CCG-59704. Ann Oncol 13(Suppl 1):107–111PubMedCrossRefGoogle Scholar
  99. Knobel David, Zouhair Abderrahim, Tsang Richard W et al (2006) Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study. BMC Cancer 6:118PubMedCrossRefGoogle Scholar
  100. Knowling MA, Harwood AR, Bergsagel DE (1983) Comparison of extra medullary plasmacytomas with solitary and multiple plasma cell tumors of bone. J Clin Oncol 1:255–262PubMedGoogle Scholar
  101. Koh ES, Sun A, Tran TH et al (2006) Clinical dose-volume histogram analysis in predicting radiation pneumonitis in Hodgkin’s lymphoma. Int J Radiat Oncol Biol Phys 66(1):223–228PubMedCrossRefGoogle Scholar
  102. Kostakoglu L (2008) Early prediction of response to therapy: the clinical implications in Hodgkin’s and non-Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging 35(8):1413–1420PubMedCrossRefGoogle Scholar
  103. Laskar S, Gupta T, Vimal S et al (2004) Consolidation radiation after complete remission in Hodgkin’s disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need? J Clin Oncol 22(1):62–68PubMedCrossRefGoogle Scholar
  104. Lee CK, Bloomfield CD, Goldman AI, Levitt SH (1980) Prognostic significance of mediastinal involvement in Hodgkin’s disease treated with curative radiation therapy. Cancer 46(11):2403–2409PubMedCrossRefGoogle Scholar
  105. Lee CK, Aeppli DM, Bloomfield CD, Levitt SH (1990) Curative radiation therapy for laparotomy-staged IA, IIA, IIIA Hodgkin’s disease: an evaluation of the gains achieved with radical radiation therapy. Int J Radiat Oncol Biol Phys 19(3):547–559PubMedCrossRefGoogle Scholar
  106. Leibenhaut MH, Hoppe RT, Efron B, Halpern J, Nelsen T, Rosenberg SA (1989) Prognostic indicators of laparotomy findings in clinical stage I-II supradiaphragmatic Hodgkin’s disease. J Clin Oncol 7(1):81–91PubMedGoogle Scholar
  107. Levitt SH, Purdy JA, Perez CA, Vijayakumar S (2006) Technical basis of radiation therapy: Practical clinical applications, 4th edn. Springer, New YorkCrossRefGoogle Scholar
  108. Liebross RH, Ha CS, Cox JD et al (1999) Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol 52:245–249PubMedCrossRefGoogle Scholar
  109. Lister TA, Crowther D, Sutcliffe SB et al (1989) Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 7(11):1630–1636PubMedGoogle Scholar
  110. Loeffler M, Diehl V, Pfreundschuh M et al (1997) Dose-response relationship of complementary radiation therapy following four cycles of combination chemotherapy in intermediate-stage Hodgkin’s disease. J Clin Oncol 15(6):2275–2287PubMedGoogle Scholar
  111. Longo DL, Young RC, Wesley M et al (1986) Twenty years of MOPP therapy for Hodgkin’s disease. J Clin Oncol 4(9):1295–1306PubMedGoogle Scholar
  112. Longo DL, Glatstein E, Duffey PL et al (1991) Radiation therapy versus combination chemotherapy in the treatment of early-stage Hodgkin’s disease: seven-year results of a prospective randomized trial. J Clin Oncol 9(6):906–917PubMedGoogle Scholar
  113. Lukes RJ, Butler JJ (1966) The pathology and nomenclature of Hodgkin’s disease. Cancer Res 26(6):1063–1083PubMedGoogle Scholar
  114. Mac Manus MP, Hoppe RT (1996) Is radiation therapy curative for stage I and II low-grade follicular lymphoma? Results of a long-term follow-up study of patients treated at Stanford University. J Clin Oncol 14:1282–1290PubMedGoogle Scholar
  115. Macdonald DA, Ding K, Gospodarowicz MK et al (2007) Patterns of disease progression and outcomes in a randomized trial testing ABVD alone for patients with limited-stage Hodgkin lymphoma. Ann Oncol 18(10):1680–1684PubMedCrossRefGoogle Scholar
  116. Mai DH, Peschel RE, Portlock C, Knowlton A, Farber L (1991) Stage I and II subdiaphragmatic Hodgkin’s disease. Cancer 68(7):1476–1481PubMedCrossRefGoogle Scholar
  117. Mauch PM (1994) Controversies in the management of early stage Hodgkin’s disease. Blood 83(2):318–329PubMedGoogle Scholar
  118. Mauch P, Ng A, Aleman B et al (2005) Report from the Rockefellar foundation sponsored international workshop on reducing mortality and improving quality of life in long-term survivors of Hodgkin’s disease, Bellagio, Italy, 9–16 July 2003. Eur J Haematol 66:68–76Google Scholar
  119. Mauch P, Greenberg H, Lewin A, Cassady JR, Weichselbaum R, Hellman S (1983) Prognostic factors in patients with subdiaphragmatic Hodgkin’s disease. Hematol Oncol 1(3):205–214PubMedCrossRefGoogle Scholar
  120. Mauch P, Tarbell N, Weinstein H et al (1988) Stage IA and IIA supradiaphragmatic Hodgkin’s disease: prognostic factors in surgically staged patients treated with mantle and para-aortic irradiation. J Clin Oncol 6(10):1576–1583PubMedGoogle Scholar
  121. Mauch P, Larson D, Osteen R et al (1990) Prognostic factors for positive surgical staging in patients with Hodgkin’s disease. J Clin Oncol 8(2):257–265PubMedGoogle Scholar
  122. Mauch PM, Kalish LA, Kadin M, Coleman CN, Osteen R, Hellman S (1993) Patterns of presentation of Hodgkin disease. Implications for etiology and pathogenesis. Cancer 71(6):2062–2071PubMedCrossRefGoogle Scholar
  123. Mauch PM, Kalish LA, Marcus KC et al (1995) Long-term survival in Hodgkin’s disease relative impact of mortality, second tumors, infection, and cardiovascular disease. Cancer J Sci Am 1(1):33–42PubMedGoogle Scholar
  124. Meignan M, Gallamini A, Haioun C, Polliack A (2010) Report on the Second International Workshop on interim positron emission tomography in lymphoma held in Menton, France, 8–9 April 2010. Leuk Lymphoma 51(12):2171–2180Google Scholar
  125. Meignan M, Gallamini A, Meignan M, Gallamini A, Haioun C (2009) Report on the first international workshop on Interim-PET-Scan in Lymphoma. Leuk Lymphoma 50(8):1257–1260PubMedCrossRefGoogle Scholar
  126. Meyer RM, Gospodarowicz MK, Connors JM et al (2005) Randomized comparison of ABVD chemotherapy with a strategy that includes radiation therapy in patients with limited-stage Hodgkin’s lymphoma: National cancer institute of canada clinical trials group and the Eastern cooperative oncology group. J Clin Oncol 23(21):4634–4642PubMedCrossRefGoogle Scholar
  127. Mill WB, Griffith R (1980) The role of radiation therapy in the management of plasma cell tumors. Cancer 45:647–652PubMedCrossRefGoogle Scholar
  128. Miller RW, van de Geijn J, Raubitschek AA, Orr K, Okunieff P, Glatstein E (1995) Dosimetric considerations in treating mediastinal disease with mantle fields: characterization of the dose under mantle blocks. Int J Radiat Oncol Biol Phys 32(4):1083–1095PubMedCrossRefGoogle Scholar
  129. Miller TP, Dahlberg S, Cassady JR et al (1998) Chemotherapy alone compared with chemotherapy plus radiation therapy for localized intermediate- and high-grade non-Hodgkin’s lymphoma. N Engl J Med 339:21–26PubMedCrossRefGoogle Scholar
  130. Mundt AJ, Connell PP, Mansur DB (1999) What is the optimal treatment volume in Hodgkin’s disease patients undergoing high-dose chemotherapy and adjuvant radiation therapy? Radiat Oncol Investig 7(6):353–359 2–8PubMedCrossRefGoogle Scholar
  131. Murawski N, Pfreundschuh M (2010) New drugs for aggressive B-cell and T-cell lymphomas. Lancet Oncol 11:1074–1085PubMedCrossRefGoogle Scholar
  132. Murphy SB, Morgan ER, Katzenstein HM, Kletzel M (2003) Results of little or no treatment for lymphocyte-predominant Hodgkin disease in children and adolescents. J Pediatr Hematol Oncol 25(9):684–687PubMedCrossRefGoogle Scholar
  133. Naumann R, Beuthien-Baumann B, Reiss A et al (2004) Substantial impact of FDG PET imaging on the therapy decision in patients with early-stage Hodgkin’s lymphoma. Br J Cancer 90(3):620–625PubMedCrossRefGoogle Scholar
  134. Neiman RS, Rosen PJ, Lukes RJ (1973) Lymphocyte-depletion Hodgkin’s disease. A clinicopathological entity. N Engl J Med 288(15):751–755PubMedCrossRefGoogle Scholar
  135. Ng AK, Mauch PM (2002) Controversies in early stage Hodgkin’s disease. Oncol (Williston Park) 16(5):588–595 598; Discussion 600, 605, 609–618Google Scholar
  136. Nogova L, Reineke T, Eich HT et al (2005) Extended field radiation therapy, combined modality treatment or involved field radiation therapy for patients with stage IA lymphocyte-predominant Hodgkin’s lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG). Ann Oncol 16(10):1683–1687PubMedCrossRefGoogle Scholar
  137. Nogova L, Reineke T, Brillant C et al (2008) Lymphocyte-predominant and classical Hodgkin’s lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol 26(3):434–439PubMedCrossRefGoogle Scholar
  138. Noordijk EM, Thomas J, Fermé C et al (2005) First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin’s lymphoma (HL). J Clin Oncol, ASCO Ann Meeting Proc 23(No. 16S, Part I of II (June 1 Supplement)):6505Google Scholar
  139. Noordijk EM, Carde P, Dupouy N et al (2006) Combined-modality therapy for clinical stage I or II Hodgkin’s lymphoma: long-term results of the European organisation for research and treatment of Cancer H7 randomized controlled trials. J Clin Oncol 24(19):3128–3135PubMedCrossRefGoogle Scholar
  140. Oberlin O, Leverger G, Pacquement H et al (1992) Low-dose radiation therapy and reduced chemotherapy in childhood Hodgkin’s disease: the experience of the French society of pediatric oncology. J Clin Oncol 10(10):1602–1608PubMedGoogle Scholar
  141. Ozsahin M, Tsang RW, Poortmans P et al (2006) Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients. Int J Radiat Oncol Biol Phys 64:210–217PubMedCrossRefGoogle Scholar
  142. Pakos EE, Fotopoulos AD, Ioannidis JP (2005) 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a meta-analysis. J Nucl Med 46(6):958–963PubMedGoogle Scholar
  143. Palos B, Kaplan HS, Karzmark CJ (1971) The use of thin lung shields to deliver limited whole-lung irradiation during mantle-field treatment of Hodgkin’s disease. Radiol 101(2):441–442Google Scholar
  144. Pavlovsky S, Maschio M, Santarelli MT et al (1988) Randomized trial of chemotherapy versus chemotherapy plus radiation therapy for stage I–II Hodgkin’s disease. J Natl Cancer Inst 80(18):1466–1473PubMedCrossRefGoogle Scholar
  145. Pellegrino B, Terrier-Lacombe MJ, Oberlin O et al (2003) Lymphocyte-predominant Hodgkin’s lymphoma in children: therapeutic abstention after initial lymph node resection—a study of the French Society of Pediatric Oncology. J Clin Oncol 21(15):2948–2952PubMedCrossRefGoogle Scholar
  146. Peters M (1950) A study of survival in Hodgkin’s disease treated radiologically. Am J Roentgenol 63:299–311Google Scholar
  147. Peters MV (1966) Prophylactic treatment of adjacent areas in Hodgkin’s disease. Cancer Res 26(6):1232–1243PubMedGoogle Scholar
  148. Petrausch U, Samaras P, Veit-Haibach P et al (2010) Hodgkin’s lymphoma in remission after first-line therapy: which patients need FDG-PET/CT for follow-up? Ann Oncol 21(5):1053–1057PubMedCrossRefGoogle Scholar
  149. Picardi M, De Renzo A, Pane F et al (2007) Randomized comparison of consolidation radiation versus observation in bulky Hodgkin’s lymphoma with post-chemotherapy negative positron emission tomography scans. Leuk Lymphoma 48(9):1721–1727PubMedCrossRefGoogle Scholar
  150. Poortmans PM, Kluin-Nelemans HC, Haaxma-Reiche H et al (2003) High-dose methotrexate-based chemotherapy followed by consolidating radiation therapy in non-AIDS-related primary central nervous system lymphoma: European organization for research and treatment of cancer lymphoma group phase II trial 20962. J Clin Oncol 21:4483–4488PubMedCrossRefGoogle Scholar
  151. Press OW, LeBlanc M, Lichter AS et al (2001) Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin’s disease. J Clin Oncol 19(22):4238–4244PubMedGoogle Scholar
  152. Prosnitz LR (1990) Hodgkin’s disease: the right dose. Int J Radiat Oncol Biol Phys 19(3):803–804PubMedCrossRefGoogle Scholar
  153. Prosnitz LR, Farber LR, Fischer JJ, Bertino JR (1973) Low dose radiation therapy and combination chemotherapy in the treatment of advanced Hodgkin’s disease. Radiol 107(1):187–193Google Scholar
  154. Raemaekers J, Burgers M, Henry-Amar M et al (1997) Patients with stage III/IV Hodgkin’s disease in partial remission after MOPP/ABV chemotherapy have excellent prognosis after additional involved-field radiation therapy: interim results from the ongoing EORTC-LCG and GPMC phase III trial The EORTC Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie. Ann Oncol 8(Suppl 1):111–114PubMedCrossRefGoogle Scholar
  155. Ragni G, Lombardi C, Santoro A, Bestetti O, Wyssling H (1983) Male infertility caused by the chemotherapy of Hodgkin’s disease: MOPP versus ABVD. Acta Eur Fertil 14(3):221–222PubMedGoogle Scholar
  156. Roach M 3rd, Kapp DS, Rosenberg SA, Hoppe RT (1987) Radiation therapy with curative intent: an option in selected patients relapsing after chemotherapy for advanced Hodgkin’s disease. J Clin Oncol 5(4):550–555PubMedGoogle Scholar
  157. Rosenberg SA, Kaplan HS (1966) Evidence for an orderly progression in the spread of Hodgkin’s disease. Cancer Res 26(6):1225–1231PubMedGoogle Scholar
  158. Ruhl U, Albrecht M, Dieckmann K et al (2001) Response-adapted radiation therapy in the treatment of pediatric Hodgkin’s disease: an interim report at 5 years of the German GPOH-HD 95 trial. Int J Radiat Oncol Biol Phys 51(5):1209–1218PubMedCrossRefGoogle Scholar
  159. Schellong G, Bramswig JH, Schwarze EW, Wannenmacher M (1988) An approach to reduce treatment and invasive staging in childhood Hodgkin’s disease: the sequence of the German DAL multicenter studies. Bull Cancer 75(1):41–51PubMedGoogle Scholar
  160. Schellong G, Bramswig JH, Hornig-Franz I, Schwarze EW, Potter R, Wannenmacher M (1994) Hodgkin’s disease in children: combined modality treatment for stages IA, IB, and IIA. Results in 356 patients of the German/Austrian pediatric study group. Ann Oncol 5(Suppl 2):113–115PubMedCrossRefGoogle Scholar
  161. Schoder H, Meta J, Yap C et al (2001) Effect of whole-body (18)F-FDG PET imaging on clinical staging and management of patients with malignant lymphoma. J Nucl Med 42(8):1139–1143PubMedGoogle Scholar
  162. Senan S, Piet A, Lagerwaard F (2007) Involved-node radiation therapy to the mediastinum. Radiother Oncol 82(1):108–109PubMedCrossRefGoogle Scholar
  163. Senff NJ, Noordijk EM, Kim YH et al (2008) European organization for research and treatment of cancer and international society for cutaneous lymphoma consensus recommendations for the management of cutaneous B-cell lymphomas. Blood 112:1600–1609PubMedCrossRefGoogle Scholar
  164. Shahidi M, Kamangari N, Ashley S, Cunningham D, Horwich A (2006) Site of relapse after chemotherapy alone for stage I and II Hodgkin’s disease. Radiother Oncol 78(1):1–5PubMedCrossRefGoogle Scholar
  165. Somers R, Tubiana M, Henry-Amar M (1989) EORTC lymphoma cooperative group studies in clinical stage I–II Hodgkin’s disease 1963–1987. Recent Results Cancer Res 117:175–181PubMedCrossRefGoogle Scholar
  166. Spaepen K, Stroobants S, Dupont P et al (2001) Prognostic value of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin’s lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol 19(2):414–419PubMedGoogle Scholar
  167. Specht L, Gray RG, Clarke MJ, Peto R (1998) Influence of more extensive radiation therapy and adjuvant chemotherapy on long-term outcome of early stage Hodgkin’s disease: a meta-analysis of 23 randomized trials involving 3, 888 patients. International Hodgkin’s disease collaborative group. J Clin Oncol 16(3):830–843PubMedGoogle Scholar
  168. van Leeuwen FE, Klokman WJ, Stovall M et al (1995) Roles of radiation therapy and smoking in lung cancer following Hodgkin’s disease. J Natl Cancer Inst 87(20):1530–1537PubMedCrossRefGoogle Scholar
  169. Vijayakumar S, Myrianthopoulos LC (1992) An updated dose-response analysis in Hodgkin’s disease. Radiother Oncol 24(1):1–13PubMedCrossRefGoogle Scholar
  170. Viviani S, Bonadonna G, Santoro A et al (1991) Alternating versus hybrid MOPP-ABVD in Hodgkin’s disease: the Milan experience. Ann Oncol 2(Suppl 2):55–62PubMedCrossRefGoogle Scholar
  171. Weihrauch MR, Re D, Bischoff S et al (2002) Whole-body positron emission tomography using 18F-fluorodeoxyglucose for initial staging of patients with Hodgkin’s disease. Ann Hematol 81(1):20–25PubMedCrossRefGoogle Scholar
  172. Weinshel EL, Peterson BA (1993) Hodgkin’s disease. CA Cancer J Clin 43(6):327–346PubMedCrossRefGoogle Scholar
  173. Yahalom J, Varsos G, Fuks Z et al (1993) Adjuvant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy after radiation therapy in stage I low-grade and intermediate-grade non-Hodgkin lymphoma. Results of a prospective randomized study. Cancer 71:2342–2350PubMedCrossRefGoogle Scholar
  174. Young RC, Canellos GP, Chabner BA, Hubbard SM, DeVita VT Jr (1978) Patterns of relapse in advanced Hodgkin’s disease treated with combination chemotherapy. Cancer 42(2 Suppl):1001–1007PubMedCrossRefGoogle Scholar
  175. Zijlstra JM, Lindauer-van der Werf G, Hoekstra OS, Hooft L, Riphagen II, Huijgens PC (2006) 18F-fluoro-deoxyglucose positron emission tomography for post-treatment evaluation of malignant lymphoma: a systematic review. Haematologica 91(4):522–529PubMedGoogle Scholar
  176. Zinzani PL, Tani M, Trisolini R et al (2007) Histological verification of positive positron emission tomography findings in the follow-up of patients with mediastinal lymphoma. Haematologica 92(6):771–777PubMedCrossRefGoogle Scholar
  177. Zittoun R, Audebert A, Hoerni B et al (1985) Extended versus involved fields irradiation combined with MOPP chemotherapy in early clinical stages of Hodgkin’s disease. J Clin Oncol 3(2):207–214PubMedGoogle Scholar
  178. Zouhair A, Weber D, Belkacémi Y et al (2002) Outcome and patterns of failure in testicular lymphoma: a multicenter Rare Cancer Network study. Int J Radiat Oncol Biol Phys 52:652–656PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  1. 1.Department of Therapeutic Radiology – Radiation OncologyUniversity of MinnesotaMinneapolisUSA
  2. 2.Department of Radiation OncologyInstitute VerbeetenTilburgThe Netherlands

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