Purpose: To evaluate the impact of the quality of involved-field radiotherapy (IFRT) on clinical outcome in patients with advanced Hodgkin's lymphoma (HL) in complete remission (CR) after six to eight cycles of mechlorethamine, vincristine, procarbazine, prednisone-doxorubicin, bleomycin, and vinblastine (MOPP-ABV) chemotherapy. Methods and Materials: A retrospective review of clinical and radiologic data, radiation charts, simulator films, and megavoltage (MV) photographs was performed. IFRT consisted of 24 Gy to all initially involved nodal areas and 16-24 Gy to all initially involved extranodal sites. Major violations were defined as no or only partial irradiation of an originally involved area, or a total dose <90% of the prescribed dose. Results: Of the 739 patients who were enrolled in the trial between 1989 and 2000, 57% achieved a CR; 152 of 172 patients randomized to IFRT actually received radiotherapy; and in 135 patients, quality control was performed. The overall major violation rate was 47%, predominantly concerning target volumes. The total dose was correct in 81% of the patients. After a median follow-up of 6.5 years, there was no difference in cumulative failure rate between patients with or without major violations. There was no relationship between incidence or site of relapse and major protocol violations. Conclusion: In advanced-stage HL patients in complete remission after six to eight cycles of MOPP-ABV, the outcome was not influenced by violation of the radiotherapy protocol.

Advanced Hodgkin's lymphoma, Combined modality treatment, Quality assurance, Quality control, Radiotherapy
dx.doi.org/10.1016/j.ijrobp.2005.03.044, hdl.handle.net/1765/63717
International Journal of Radiation: Oncology - Biology - Physics
Department of Radiation Oncology

Aleman, B.M.P, Eghbali, H, Noordijk, E.M, Tomšič, R, Meerwaldt, J.H, Poortmans, P.M.P, … Lievens, Y. (2005). Quality control of involved-field radiotherapy in patients with advanced Hodgkin's lymphoma (EORTC 20884). International Journal of Radiation: Oncology - Biology - Physics (Vol. 63, pp. 1184–1190). doi:10.1016/j.ijrobp.2005.03.044