Am J Clin Oncol 2016 12;39(6):535-544
*University of Rochester Medical Center, Rochester †††Memorial Sloan Kettering Cancer Center, American Society of Clinical Oncology, New York, NY †Stanford Cancer Center, American Society of Clinical Oncology, Stanford ‡University of Southern California Keck School of Medicine, Los Angeles, CA §University of Texas MD Anderson Cancer Center, Houston ¶University of Texas Health Science Center at San Antonio, San Antonio, TX ∥Emory University, American Society of Clinical Oncology, Atlanta, GA #University of Florida Proton Therapy Institute, Jacksonville **University of Florida, Gainesville, FL ††St. Jude Children's Research Hospital, American Society of Clinical Oncology, Memphis, TN ‡‡University of Pennsylvania Health System, Philadelphia, PA §§Yale University School of Medicine, New Haven, CT ∥∥Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN ¶¶The University of Chicago, American Society of Hematology, Chicago, IL ##Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD ***Massachusetts General Hospital, Boston, MA.
This topic addresses the treatment of newly diagnosed patients with favorable prognosis stage I and II Hodgkin lymphoma. In most cases, combined modality therapy (chemotherapy followed by involved site radiation therapy) constitutes the current standard of care. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. By combining the most recent medical literature and expert opinion, this revised guideline can aid clinicians in the appropriate use of combined modality therapy for favorable prognosis stage I and II Hodgkin lymphoma. Increasing information about the late effects of treatment has led to attempts to decrease toxicity by using less chemotherapy (decreased duration and/or intensity or different agents) and less radiation therapy (reduced volume and/or dose) while maintaining excellent efficacy.