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April 28, 2012 長庚醫院 放射腫瘤科 林信吟醫師

Hodgkin’s Lymphoma (HL) Chart Round and Overview, focusing on Early-stage Favorable HL, in the era of CMT (Combined Modality Treatment). April 28, 2012 長庚醫院 放射腫瘤科 林信吟醫師. Q : Demographics & descriptive Epidemiology of HL in Taiwan?. Current status in the US can also be described

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April 28, 2012 長庚醫院 放射腫瘤科 林信吟醫師

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  1. Hodgkin’s Lymphoma (HL)Chart Round and Overview, focusing on Early-stage Favorable HL, in the era of CMT (Combined Modality Treatment) April 28, 2012 長庚醫院 放射腫瘤科 林信吟醫師

  2. Q:Demographics & descriptive Epidemiology of HL in Taiwan? Current status in the US can also be described Try to point out the differences between the US and Taiwan

  3. Q:Describe pathology in brief

  4. Q:Staging Classification

  5. Q:Unfavorable factors for early-stage HL?

  6. Q:Unfavorable factors for advanced-stage HL? International Prognostic Score (IPS)

  7. Q:In early-stage favorable HL, compare outcomes with CMT vs. RT alone In the 1990s, CRT vs. RT alone was evaluated at least 4 major RCTs:

  8. Q:In HL patients receiving CMT, how about RT volume?(Is more extensive RT volume than IFRT necessary?) At least 4 RCTs have compared IFRT to more extensive RT fields in HL pts receiving CMT:

  9. EORTC H8 trial addressed the issue of RT volume

  10. Q:In early-stage favorable HL,summarize the evidence to support the implementation of reduced RT dose after induction C/T Use of < 30 Gy in early-stage favorable HL after initial C/T has been studied in two RCTs: GHSG H10 trial EORTC-GELA H9F trial

  11. Q:The investigation of C/T as a single modality in limited-stage disease?【CMT vs. C/T alone】【After initial C/T ---> Consolidative RT vs. Observation alone】

  12. In addition • EORTC H9-F trials compare 3 radiation dose levels (one of which is the arm without consolidative RT after initial C/T) • Interim results show CMT indeed provides much better tumor control (HR = 0.27【0.17, 0.43】) as compared to C/T alone group • 【Ongoing】In patients who have a PET-documented CR after 2 cycles of C/T, EORTC H10 trial is to compare ABVD alone vs. ABVD + INRT

  13. Q:Risk of long-term solid cancer among survivors of HL?

  14. Q:In early-stage Unfavorable HL, whether Tx results can be improved with more intensive C/T followed by dose-reduced IFRT? GHSG HD 11 trial has addressed this issue

  15. Q:Prognostic Value of early interim FDG-PET in HL?

  16. Q:Whether patients with FDG-PET (+) during and/or after C/T can be rendered disease free with consolidative IFRT?

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