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Is Combination Of Chemotherapy With Limited Field Radiation Treatment Effective For Hodgkin's Lymphoma?
Question: I have been diagnosed with classic Hosgins Lymphoma (its stage 1A) NSHL. I am 32 male in perfect health otherwise. I dont smoke. tumor has mass of 7.3 X 5.4 X 3.3 mass in my right upper chest. I've been on ABVD chemo almost completed 2 cycles now. The big decision now is to do just chemo or chemo with radiation (limited field rad)? Chemo is a breeze. Dr is ordering Pet scan at end of 2 cycles but I don't know if this makes sense.. in my opinion we should do pet scan at end of 3rd cycle. I want to tell him lets do 3 cycles followed by rad even if pet comes back clean I would opt to do rad. what should I do? I'm looking for specific numbers as well showing risks of death / secondary cancers from rad.. the question also becomes how many of those people smoked or had HIV or old age or other problems... I don't have those problems..
Thank you!
XXXXXXX
Thank you!
XXXXXXX
Brief Answer:
You should go for combined chemotherapy plus limited field radiation.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have diagnosed with nodular sclerosis hodgkin's lymphoma. As you said its single mass with maximum diameter of 7.3 cm. You are otherwise healthy without any symptoms.
So you have early disease but its extranodal mass so it comes under early unfavourable category.
Nowadays treatment of choice is combination of chemotherapy with limited field radiation treatment.
ABVD is the standard chemotherapy regimen.
You should go for PET scan after 2 cycles of chemotherapy.
PET scan early after starting chemotherapy has demonstrated to have powerful prognostic ability.
This enables assessment of an individuals response to chemotherapy as the PET activities switches off rapidly in patients who are responding.
So we can detect response of treatment very early and accordingly we can change the regimen if needed.
So you should go for PET scan after 2 cycles and need combination of chemotherapy plus radiation therapy.
Risk of radiation related cancers are there. AML, bone cancer, lung cancer, GI cancer are some of them. But it depends on many factors and risk benefits ratio is favorable in your case.
So don't worry about radiation risk.
Consult your doctor and plan accordingly.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
You should go for combined chemotherapy plus limited field radiation.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have diagnosed with nodular sclerosis hodgkin's lymphoma. As you said its single mass with maximum diameter of 7.3 cm. You are otherwise healthy without any symptoms.
So you have early disease but its extranodal mass so it comes under early unfavourable category.
Nowadays treatment of choice is combination of chemotherapy with limited field radiation treatment.
ABVD is the standard chemotherapy regimen.
You should go for PET scan after 2 cycles of chemotherapy.
PET scan early after starting chemotherapy has demonstrated to have powerful prognostic ability.
This enables assessment of an individuals response to chemotherapy as the PET activities switches off rapidly in patients who are responding.
So we can detect response of treatment very early and accordingly we can change the regimen if needed.
So you should go for PET scan after 2 cycles and need combination of chemotherapy plus radiation therapy.
Risk of radiation related cancers are there. AML, bone cancer, lung cancer, GI cancer are some of them. But it depends on many factors and risk benefits ratio is favorable in your case.
So don't worry about radiation risk.
Consult your doctor and plan accordingly.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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