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Treatment

In contrast to many other malignant tumors, Hodgkin lymphomas are very sensitive to chemotherapy and radiotherapy. Due to this fact, the majority of Hodgkin lymphoma patients can today be cured by means of adequate therapeutic measures.

In most cases, chemotherapy and radiotherapy are used in combination. Chemotherapy is conducted first and is followed by radiotherapy. The following table provides an overview of stage-adapted therapy:

 

Ann Arbor staging system

IA, IB, IIA IIB IIIA IIIB, IV

Risk factors

none

Early stage

Trial: HD16

or

2 x ABVD + 20 Gy IF

? 3 LN areas

Intermediate stage

Advanced stage

Trial: HD17

or

2 x esc. BEACOPP + 2 x ABVD + 30 Gy IF

Trial HD18 (18 –60 years)

or

6 x esc. BEACOPP + RT in case of PET-positive residual tumor ? 2.5 cm

or

in patients > 60 years

6-8 x ABVD + RT on residual tumor ? 1.5cm

High ESR

Large mediastinal mass

   

Extranodal disease

 

Abbreviations: LN = lymph nodes, ESR = erythrocyte sedimentation rate, esc. = escalated, IF = involved field, RT = radiotherapy

Surgical interventions (tumor removal by means of surgery) are only used for diagnostic purposes (lymph node removal/biopsy) and do not have a healing effect.

Treatment should start as soon as possible after Hodgkin lymphoma was diagnosed to avoid further progression of the disease. Chemotherapy should only be conducted by experienced physicians in hospitals or medical practices specialized in hemato-oncologic diseases. The irradiation techniques used in Hodgkin lymphoma are highly sophisticated and should only be performed by radiotherapy centers experienced in this kind of treatment. In many cases, both treatment modalities can be administered in an ambulant setting and do not require hospitalization.