Despite data showing an increased 10-year survival rate among early-stage Hodgkin's disease patients who receive consolidated radiation therapy, the treatment method is being used less, researchers reported at the American Society for Radiation Oncology (ASTRO) meeting in San Francisco.
Their study evaluated clinical features and survival outcomes from 41,502 patients diagnosed with stage I and II Hodgkin's disease from 1998 to 2011 using the National Cancer Data Base (NCDB). The research team, led by Dr. Rahul Parikh from Icahn School of Medicine at Mount Sinai, found that patients who received consolidated radiation therapy had an 84% 10-year survival rate, compared with 76% for those who didn't receive radiation therapy. However, radiation therapy utilization in this patient population dipped from 56% to 41% during the study period.
Multiagent chemotherapy was administered to 39,842 (96%) of the patients, and 20,441 (49%) of patients received a median radiation therapy dose of 30.6 Gy. Overall, the study showed a 10-year survival rate of 80.8%. The increase in overall 10-year survival for those patients receiving radiation therapy was statistically significant.
In 88.4% of the patients who did not receive radiation therapy, the physician-reported reason was that it was not part of the planned initial treatment strategy, according to the researchers. Also, use of radiation therapy was associated with younger patients who were in a higher socioeconomic bracket, had access to health insurance, and received treatment at comprehensive cancer centers (all p < 0.0001).
It's important that these findings be recognized as potential barriers to care, the authors noted.
"Given the survival benefit demonstrated in this study, radiotherapy should be included in the combined modality approach of multiagent chemotherapy followed by consolidation [radiation therapy] in order to maintain high overall survival rates for this curable disease," Parikh said in a statement.
