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### Early-Stage Favorable Hodgkin's Lymphoma: Insights on CMT and Radiation Therapy Strategies ###

This comprehensive overview focuses on early-stage favorable Hodgkin’s Lymphoma (HL), highlighting the latest findings from combined modality treatment (CMT) strategies. It discusses demographics and epidemiology in Taiwan and comparisons with the US, including a brief pathology review and staging classification. Key topics include unfavorable factors for different stages of HL, the impact of CMT on treatment outcomes, radiation therapy volume considerations, and evidence supporting reduced radiation doses post-chemotherapy. Additionally, the document explores long-term risks, interim FDG-PET prognostics, and trial findings regarding treatment effectiveness. ###

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### Early-Stage Favorable Hodgkin's Lymphoma: Insights on CMT and Radiation Therapy Strategies ###

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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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