Abstract
Radiotherapy (RT) is a key modality in the treatment of Hodgkin lymphoma (HL). A better understanding of the role of RT in the management of HL is being achieved through clinical trial activities. Large cooperative groups, e.g., the German Hodgkin Study Group (GHSG) or the European Organization for Research and Treatment of Cancer (EORTC), established extensive quality assurance programs within their multicenter trials. The GHSG HD4 trial demonstrated the importance of this. Major protocol violations, with particular reference to the design of the radiation fields, were associated with a statistically significant reduction in freedom from treatment failure. The quality control program in this trial was of retrospective manner post treatment and highlighted two key factors. (1) the need for a real-time quality control program which could influence the actual delivery of treatment and (2) a close cooperation between diagnostic radiology and radiotherapy to use all imaging information for an optimal design of the individual radiotherapy treatment plan as required by the protocol prescriptions. Therefore, new radiotherapy quality assurance programs were initiated including a telemedicine facility using IT-based communication infrastructure for imaging transfer at the Cologne radiotherapy reference center.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aleman BM, Girinsky T, van der Maazen RW et al (2005) Quality control of involved-field radiotherapy in patients with advanced Hodgkin’s lymphoma (EORTC 20884). Int J Radiat Oncol Biol Phys 63:1184–1190
Dieckmann K, Potter R, Wagner W et al (2002) Up-front centralized data review and individualized treatment proposals in a multicenter pediatric Hodgkin’s disease trial with 71 participating hospitals: the experience of the German-Austrian pediatric multicenter trial DAL-HD-90. Radiother Oncol 62:191–200
Diehl V, Brillant C, Engert A et al (2005) Recent interim analysis of the HD11 trial of the GHSG: intensification of chemotherapy and reduction of radiation dose in early unfavourable stage Hodgkin’s lymphoma. Blood 106:240a–241a
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 radiotherapy alone. Int J Radiat Oncol Biol Phys 36:305–310
Duhmke E, Franklin J, Pfreundschuh M et al (2001) Low-dose radiation is sufficient for the noninvolved extended-field treatment in favorable early-stage Hodgkin’s disease: long-term results of a randomized trial of radiotherapy alone. J Clin Oncol 19:2905–2914
Eich HT, Muller RP, Schneeweiss A et al (2004a) Initiation of a teleradiotherapeutic network for patients in German lymphoma studies. Int J Radiat Oncol Biol Phys 58:805–808
Eich HT, Staar S, Gossmann A et al (2004b) Centralized radiation oncologic review of cross-sectional imaging of Hodgkin’s disease leads to significant changes in required involved field-results of a quality assurance program of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 58:1121–1127
Eich H, Mueller R, Engert A et al (2005) Comparison of 30 Gy versus 20 Gy involved field radiotherapy after two versus four cycles ABVD in early stage Hodgkin’s lymphoma: interim analysis of the German Hodgkin Study Group trial HD10. Int J Radiat Oncol Biol Phys 63:1–2
Eich HT, Engenhart-Cabillic R, Hansemann K et al (2008) Quality control of involved field radiotherapy in patients with early-favorable (HD10) and early-unfavorable (HD11) Hodgkin’s lymphoma: an analysis of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 71:1419–1424
Engert A, Schiller P, Josting A et al (2003) Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy 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 21:3601–3608
Engert A, Franklin J, Eich HT et al (2007) Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol 25:3495–3502
Hoppe RT, Hanlon AL, Hanks GE et al (1994) Progress in the treatment of Hodgkin’s disease in the United States, 1973 versus 1983. The patterns of care study. Cancer 74:3198–3203
Hughes DB, Smith AR, Hoppe R et al (1995) Treatment planning for Hodgkin’s disease: a patterns of care study. Int J Radiat Oncol Biol Phys 33:519–524
Kinzie JJ, Hanks GE, MacLean CJ et al (1983) Patterns of care study: Hodgkin’s disease relapse rates and adequacy of portals. Cancer 52:2223–2226
Muller RP, Eich HT (2005a) Current role of radiotherapy in the treatment of Hodgkin’s disease. In: Perez CA, Brady LW, Halperin EC et al (eds) Update principles and practice of radiation oncology. Lippincott Williams & Wilkins, Philadelphia, PA
Muller RP, Eich HT (2005b) The development of quality assurance programs for radiotherapy within the German Hodgkin Study Group (GHSG). Introduction, continuing work, and results of the radiotherapy reference panel. Strahlenther Onkol 181:557–566
Yahalom J, Mauch P (2002) The involved field is back: issues in delineating the radiation field in Hodgkin’s disease. Ann Oncol 13(Suppl 1):79–83
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Berlin Heidelberg
About this chapter
Cite this chapter
Müller, RP., Eich, H.T. (2011). Quality Assurance of Radiotherapy for Hodgkin Lymphoma. In: Specht, L., Yahalom, J. (eds) Radiotherapy for Hodgkin Lymphoma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78944-4_11
Download citation
DOI: https://doi.org/10.1007/978-3-540-78944-4_11
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-78455-5
Online ISBN: 978-3-540-78944-4
eBook Packages: MedicineMedicine (R0)