The paper by Radford et al clearly shows that treatment with ABVD chemotherapy (CT) is noninferior to treatment with radiotherapy (RT) in early-stage Hodgkin’s lymphoma.1 Equipments which deliver RT worldwide are heterogeneous in its features, efficacy and conditions, and outdated radiotherapy equipments are still operating in underprivileged circumstances, such as those prevailing in developing (middle income) countries.2 With this idea in mind we published a study assessing the efficacy of CT alone in the treatment of early stage Hodgkin’s lymphoma and we found that “it is better a conventional CT than a suboptimal RT in the treatment of early-stage Hodgkin’s disease”.2,3
In certain conditions, therapeutic choices are based not only on scientific data, but also in economic circumstances which lead into differentiated efficacy of the therapeutic approaches.4 The data in the paper by Radford et al, scientifically support the decision to use CT alone in the treatment of early-stage Hogkin’s lymphoma, in circumstances in which RT is less than optimal and in other scenarios.
REFERENCES
- Radford J, Illidge T, Counsell N, Hancock B, et al. Results of a trial of PET-directed therapy for early stage Hodgkin’s lymphoma. N Engl J Med 2015;372:1598-1607.
- Ruiz-Argüelles GJ, Gómez-Almaguer D. Chemotherapy in early stage Hodgkin’s disease. Sem Oncol 1997;24:XIV.
- Ruiz-Argüelles GJ, Gómez-Almaguer D, Apreza-Molina MG. Chemotherapy alone may be an efficient alternative in the treatment of early stage Hodgkin’s disease if optimal radiotherapy is not available. Leukemia Lymph 1997;27:179-183.
- Ruiz-Argüelles GJ, Tarín-Arzaga LC, González-Carrillo ML, Gutiérrez-Riveroll KI, et al. Therapeutic choices in patients with Ph1 (+) chronic myelogenous leukemia living in México in the tyrosine kinase inhibitors (TKI) era: Stem cell transplantation or TKI’s? Bone Marrow Transplant 2008;42:23-28.