Hodgkin's lymphoma medical therapy: Difference between revisions
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*Chemotherapy | *Chemotherapy | ||
:* Drug Regimen: (''[[ABVD]]'') [[Adriamycin]] {{and}} [[Bleomycin]] {{and}} [[Vinblastine]] {{and}} [[Dacarbazine]] | :* Drug Regimen: (''[[ABVD]]'') [[Adriamycin]] {{and}} [[Bleomycin]] {{and}} [[Vinblastine]] {{and}} [[Dacarbazine]] | ||
* Radiation therapy | * Radiation therapy | ||
:* External beam radiation therapy may be offered. It is given after chemotherapy to the areas where the Hodgkin's lymphoma was initially found or before chemotherapy to shrink a large tumor. Radiation therapy may be given alone: | :* External beam radiation therapy may be offered. It is given after chemotherapy to the areas where the Hodgkin's lymphoma was initially found or before chemotherapy to shrink a large tumor. Radiation therapy may be given alone: | ||
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* Radiation therapy | * Radiation therapy | ||
External beam radiation therapy may be offered for stage III Hodgkin's lymphoma. It is given after chemotherapy if the Hodgkin's lymphoma is localized in an area of the body and can be included in the radiation field. | External beam radiation therapy may be offered for stage III Hodgkin's lymphoma. It is given after chemotherapy if the Hodgkin's lymphoma is localized in an area of the body and can be included in the radiation field. | ||
===Recurrent disease=== | |||
* Chemotherapy | |||
:* Drug Regimen: (''[[ABVD]]'') [[Adriamycin]] {{and}} [[Bleomycin]] {{and}} [[Vinblastine]] {{and}} [[Dacarbazine]] | |||
:* Drug Regimen: ([[Stanford V]]) [[Adriamycin]] {{and}} [[Bleomycin]] {{and}} [[Vinblastine]] {{and}} [[Vincristine]] {{and}} [[Mechlorethamine]] {{and}} [[Etoposide]] {{and}} [[Prednisone]] | |||
:* Drug Regimen: ([[BEACOPP]]) [[Bleomycin]] {{and}} [[Etoposide]] {{and}} [[Adriamycin]] {{and}} [[Cyclophosphamide]] {{and}} [[Oncovin]] {{and}} [[Procarbazine]] {{and}} [[Prednisone]] | |||
:* Drug Regimen: (GDP)[[Gemcitabine]] {{and}} [[Dexamethasone]] {{and}} [[Cisplatin]] | |||
:* Drug Regimen: (CBV) [[Cyclophosphamide]] {{and}} [[Carmustine]] {{and}} [[Etoposide]] {{and}} stem cell transplant | |||
:* Drug Regimen: (BEAM) [[Carmustine]] {{and}} [[Etoposide]] {{and}} [[Cytarabine]] {{and}} [[Melphalan]] {{and}} stem cell transplant | |||
* Radiation therapy | |||
External beam radiation therapy may be offered for relapsed or primary refractory Hodgkin's lymphoma if the original treatment was chemotherapy only and the Hodgkin's lymphoma remains or returns in only a single area. Radiation therapy may be given alone or with more chemotherapy. Radiation therapy may also be used along with chemotherapy in preparation for a stem cell transplant. | |||
* Stem cell transplant | |||
A stem cell transplant may be offered for Hodgkin's lymphoma that relapses within a few months of original treatment or for refractory disease. | |||
===Long-term complications of chemotherapy or radiation therapy=== | ===Long-term complications of chemotherapy or radiation therapy=== | ||
* Bone marrow diseases (such as leukemia) | * Bone marrow diseases (such as leukemia) | ||
* Heart disease | * Heart disease | ||
Revision as of 21:08, 10 September 2015
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Hodgkin's lymphoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hodgkin's lymphoma medical therapy On the Web |
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American Roentgen Ray Society Images of Hodgkin's lymphoma medical therapy |
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Risk calculators and risk factors for Hodgkin's lymphoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
The optimal therapy for Hodgkin's lymphoma depends on the stage at diagnosis, age, type, and size of tumor. The predominant therapy for Hodgkin's lymphoma is chemotherapy. Adjunctive radiation may be required.
Medical Therapy
Treatment depends on the following:
- The type of Hodgkin's lymphoma (most people have classic Hodgkin's)
- The stage (where the disease has spread)
- Whether the tumor is more than 4 inches (10 cm) wide
- Your age and other medical issues
- Other factors, including weight loss, night sweats, and fever
- Tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future. Staging is needed to determine your treatment plan. Stages of Hodgkin's lymphoma range from I to IV. The higher the staging number, the more advanced the cancer.
Treatment depends on stage of the cancer:
- Stages I and II (limited disease) can be treated with radiation therapy, chemotherapy, or both.
- Stage III is treated with chemotherapy alone, or a combination of radiation therapy and chemotherapy.
- Stage IV (extensive disease) is most often treated with chemotherapy alone.
- People with Hodgkin's lymphoma that returns after treatment or does not respond to the first treatment may receive high-dose chemotherapy. That is followed by an autologous stem cell transplant.
Chemotherapy
- Drug Regimen: (MOPP) Mechlorethamine AND Oncovin AND Prednisone AND Procarbazine
- Drug Regimen: (ABVD) Adriamycin AND Bleomycin AND Vinblastine AND Dacarbazine
- Drug Regimen: (Stanford V) Adriamycin AND Bleomycin AND Vinblastine AND Vincristine AND Mechlorethamine AND Etoposide AND Prednisone
- Drug Regimen: (BEACOPP) Bleomycin AND Etoposide AND Adriamycin AND Cyclophosphamide AND Oncovin AND Procarbazine AND Prednisone
Radiotherapy
- Radiation oncologists deliver external beam radiation therapy to the lymphoma from a machine called linear accelerator which produces high energy X Rays and electrons. Patients usually describe treatments as painless and similar to getting an X-ray. Treatments last less than 30 minutes each.
- For lymphomas, there are a few different ways radiation oncologists target the cancer cells.
- Involved field radiation is when the radiation oncologists give radiation only to those parts of the patient's body known to have the cancer. Very often, this is combined with chemotherapy.
- Radiation therapy directed above the diaphragm to the neck, chest and/or underarms is called mantle field radiation.
- Radiation to below the diaphragm to the abdomen, spleen and/or pelvis is called inverted-Y field radiation.
- Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread.[1]
stage I & II Hodgkin's lymphoma
- Chemotherapy
- Drug Regimen: (ABVD) Adriamycin AND Bleomycin AND Vinblastine AND Dacarbazine
- Radiation therapy
- External beam radiation therapy may be offered. It is given after chemotherapy to the areas where the Hodgkin's lymphoma was initially found or before chemotherapy to shrink a large tumor. Radiation therapy may be given alone:
- If the person cannot tolerate chemotherapy because of other health issues
- If the Hodgkin's lymphoma is localized in a small area of lymph nodes
- For nodular lymphocyte predominant Hodgkin's lymphoma when no B symptoms are present
Stage III & IV Hodgkin's lymphoma
- Chemotherapy
- Drug Regimen: (MOPP) Mechlorethamine AND Oncovin AND Prednisone AND Procarbazine
- Drug Regimen: (ABVD) Adriamycin AND Bleomycin AND Vinblastine AND Dacarbazine
- Drug Regimen: (Stanford V) Adriamycin AND Bleomycin AND Vinblastine AND Vincristine AND Mechlorethamine AND Etoposide AND Prednisone
- Drug Regimen: (BEACOPP) Bleomycin AND Etoposide AND Adriamycin AND Cyclophosphamide AND Oncovin AND Procarbazine AND Prednisone
- Radiation therapy
External beam radiation therapy may be offered for stage III Hodgkin's lymphoma. It is given after chemotherapy if the Hodgkin's lymphoma is localized in an area of the body and can be included in the radiation field.
Recurrent disease
- Chemotherapy
- Drug Regimen: (ABVD) Adriamycin AND Bleomycin AND Vinblastine AND Dacarbazine
- Drug Regimen: (Stanford V) Adriamycin AND Bleomycin AND Vinblastine AND Vincristine AND Mechlorethamine AND Etoposide AND Prednisone
- Drug Regimen: (BEACOPP) Bleomycin AND Etoposide AND Adriamycin AND Cyclophosphamide AND Oncovin AND Procarbazine AND Prednisone
- Drug Regimen: (GDP)Gemcitabine AND Dexamethasone AND Cisplatin
- Drug Regimen: (CBV) Cyclophosphamide AND Carmustine AND Etoposide AND stem cell transplant
- Drug Regimen: (BEAM) Carmustine AND Etoposide AND Cytarabine AND Melphalan AND stem cell transplant
- Radiation therapy
External beam radiation therapy may be offered for relapsed or primary refractory Hodgkin's lymphoma if the original treatment was chemotherapy only and the Hodgkin's lymphoma remains or returns in only a single area. Radiation therapy may be given alone or with more chemotherapy. Radiation therapy may also be used along with chemotherapy in preparation for a stem cell transplant.
- Stem cell transplant
A stem cell transplant may be offered for Hodgkin's lymphoma that relapses within a few months of original treatment or for refractory disease.
Long-term complications of chemotherapy or radiation therapy
- Bone marrow diseases (such as leukemia)
- Heart disease
- Inability to have children (infertility)
- Lung problems
- Other cancers
- Thyroid problems
- Chemotherapy can cause low blood cell counts, which can lead to an increased risk of bleeding, infection, and anemia.
References
- ↑ "RTanswers.com". RTanswers.com. 2010-12-03. Retrieved 2012-08-26.