Adult nodular lymphocyte-predominant Hodgkin lymphoma: treatment modality utilization and survival

Clayton Alonso, Sunil W. Dutta, Nandita Mitra, Daniel J. Landsburg, Nicholas G. Zaorsky, Surbhi Grover, Jennifer Peterson, Daniel M. Trifiletti

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Early-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is associated with a favorable prognosis. Our aim was to evaluate the patterns of care of radiotherapy utilization in this disease and to define the relationship between treatment modality and survival. The National Cancer Database was queried for patients with stages I-II NLPHL diagnosed from 2004 to 2012. Patients were compared based on primary therapy into four categories: radiotherapy, chemotherapy, both, or neither. Covariate-adjusted and propensity score-weighted (PS) Cox proportional hazards models were used, adjusting for potential factors confounding survival. After exclusions, 1420 patients were evaluated, 571 (40%) received radiotherapy alone, 318 (22%) received chemotherapy alone, 351 (25%) received both, and 180 (13%) received neither. Younger patient age (P = 0.001), female gender (P = 0.019), and chemotherapy use (P < 0.001) were associated with decreased radiotherapy utilization. On PS, radiation alone (HR = 0.298, P < 0.001) and chemoradiotherapy (HR = 0.258, P < 0.001) were associated with improved survival compared to no upfront therapy, but the use of chemotherapy alone did not statistically differ compared to no initial therapy (HR = 0.784, P = 0.078). In this large database analysis, over one-third of patients with early-stage NLPHL did not receive radiotherapy as a component of initial therapy. The omission of upfront radiotherapy was associated with inferior survival.

Original languageEnglish (US)
Pages (from-to)1118-1126
Number of pages9
JournalCancer medicine
Volume7
Issue number4
DOIs
StatePublished - Apr 2018

Fingerprint

Hodgkin Disease
Radiotherapy
Survival
Drug Therapy
Propensity Score
Therapeutics
Databases
Chemoradiotherapy
Proportional Hazards Models
Radiation
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Alonso, C., Dutta, S. W., Mitra, N., Landsburg, D. J., Zaorsky, N. G., Grover, S., ... Trifiletti, D. M. (2018). Adult nodular lymphocyte-predominant Hodgkin lymphoma: treatment modality utilization and survival. Cancer medicine, 7(4), 1118-1126. https://doi.org/10.1002/cam4.1383
Alonso, Clayton ; Dutta, Sunil W. ; Mitra, Nandita ; Landsburg, Daniel J. ; Zaorsky, Nicholas G. ; Grover, Surbhi ; Peterson, Jennifer ; Trifiletti, Daniel M. / Adult nodular lymphocyte-predominant Hodgkin lymphoma : treatment modality utilization and survival. In: Cancer medicine. 2018 ; Vol. 7, No. 4. pp. 1118-1126.
@article{bdaa93685d834ea182075c86d2a2e882,
title = "Adult nodular lymphocyte-predominant Hodgkin lymphoma: treatment modality utilization and survival",
abstract = "Early-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is associated with a favorable prognosis. Our aim was to evaluate the patterns of care of radiotherapy utilization in this disease and to define the relationship between treatment modality and survival. The National Cancer Database was queried for patients with stages I-II NLPHL diagnosed from 2004 to 2012. Patients were compared based on primary therapy into four categories: radiotherapy, chemotherapy, both, or neither. Covariate-adjusted and propensity score-weighted (PS) Cox proportional hazards models were used, adjusting for potential factors confounding survival. After exclusions, 1420 patients were evaluated, 571 (40{\%}) received radiotherapy alone, 318 (22{\%}) received chemotherapy alone, 351 (25{\%}) received both, and 180 (13{\%}) received neither. Younger patient age (P = 0.001), female gender (P = 0.019), and chemotherapy use (P < 0.001) were associated with decreased radiotherapy utilization. On PS, radiation alone (HR = 0.298, P < 0.001) and chemoradiotherapy (HR = 0.258, P < 0.001) were associated with improved survival compared to no upfront therapy, but the use of chemotherapy alone did not statistically differ compared to no initial therapy (HR = 0.784, P = 0.078). In this large database analysis, over one-third of patients with early-stage NLPHL did not receive radiotherapy as a component of initial therapy. The omission of upfront radiotherapy was associated with inferior survival.",
author = "Clayton Alonso and Dutta, {Sunil W.} and Nandita Mitra and Landsburg, {Daniel J.} and Zaorsky, {Nicholas G.} and Surbhi Grover and Jennifer Peterson and Trifiletti, {Daniel M.}",
year = "2018",
month = "4",
doi = "10.1002/cam4.1383",
language = "English (US)",
volume = "7",
pages = "1118--1126",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
number = "4",

}

Alonso, C, Dutta, SW, Mitra, N, Landsburg, DJ, Zaorsky, NG, Grover, S, Peterson, J & Trifiletti, DM 2018, 'Adult nodular lymphocyte-predominant Hodgkin lymphoma: treatment modality utilization and survival', Cancer medicine, vol. 7, no. 4, pp. 1118-1126. https://doi.org/10.1002/cam4.1383

Adult nodular lymphocyte-predominant Hodgkin lymphoma : treatment modality utilization and survival. / Alonso, Clayton; Dutta, Sunil W.; Mitra, Nandita; Landsburg, Daniel J.; Zaorsky, Nicholas G.; Grover, Surbhi; Peterson, Jennifer; Trifiletti, Daniel M.

In: Cancer medicine, Vol. 7, No. 4, 04.2018, p. 1118-1126.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adult nodular lymphocyte-predominant Hodgkin lymphoma

T2 - treatment modality utilization and survival

AU - Alonso, Clayton

AU - Dutta, Sunil W.

AU - Mitra, Nandita

AU - Landsburg, Daniel J.

AU - Zaorsky, Nicholas G.

AU - Grover, Surbhi

AU - Peterson, Jennifer

AU - Trifiletti, Daniel M.

PY - 2018/4

Y1 - 2018/4

N2 - Early-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is associated with a favorable prognosis. Our aim was to evaluate the patterns of care of radiotherapy utilization in this disease and to define the relationship between treatment modality and survival. The National Cancer Database was queried for patients with stages I-II NLPHL diagnosed from 2004 to 2012. Patients were compared based on primary therapy into four categories: radiotherapy, chemotherapy, both, or neither. Covariate-adjusted and propensity score-weighted (PS) Cox proportional hazards models were used, adjusting for potential factors confounding survival. After exclusions, 1420 patients were evaluated, 571 (40%) received radiotherapy alone, 318 (22%) received chemotherapy alone, 351 (25%) received both, and 180 (13%) received neither. Younger patient age (P = 0.001), female gender (P = 0.019), and chemotherapy use (P < 0.001) were associated with decreased radiotherapy utilization. On PS, radiation alone (HR = 0.298, P < 0.001) and chemoradiotherapy (HR = 0.258, P < 0.001) were associated with improved survival compared to no upfront therapy, but the use of chemotherapy alone did not statistically differ compared to no initial therapy (HR = 0.784, P = 0.078). In this large database analysis, over one-third of patients with early-stage NLPHL did not receive radiotherapy as a component of initial therapy. The omission of upfront radiotherapy was associated with inferior survival.

AB - Early-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is associated with a favorable prognosis. Our aim was to evaluate the patterns of care of radiotherapy utilization in this disease and to define the relationship between treatment modality and survival. The National Cancer Database was queried for patients with stages I-II NLPHL diagnosed from 2004 to 2012. Patients were compared based on primary therapy into four categories: radiotherapy, chemotherapy, both, or neither. Covariate-adjusted and propensity score-weighted (PS) Cox proportional hazards models were used, adjusting for potential factors confounding survival. After exclusions, 1420 patients were evaluated, 571 (40%) received radiotherapy alone, 318 (22%) received chemotherapy alone, 351 (25%) received both, and 180 (13%) received neither. Younger patient age (P = 0.001), female gender (P = 0.019), and chemotherapy use (P < 0.001) were associated with decreased radiotherapy utilization. On PS, radiation alone (HR = 0.298, P < 0.001) and chemoradiotherapy (HR = 0.258, P < 0.001) were associated with improved survival compared to no upfront therapy, but the use of chemotherapy alone did not statistically differ compared to no initial therapy (HR = 0.784, P = 0.078). In this large database analysis, over one-third of patients with early-stage NLPHL did not receive radiotherapy as a component of initial therapy. The omission of upfront radiotherapy was associated with inferior survival.

UR - http://www.scopus.com/inward/record.url?scp=85042424442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042424442&partnerID=8YFLogxK

U2 - 10.1002/cam4.1383

DO - 10.1002/cam4.1383

M3 - Article

C2 - 29479868

AN - SCOPUS:85042424442

VL - 7

SP - 1118

EP - 1126

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 4

ER -