TY - JOUR
T1 - Primary therapy and relative survival in classical Hodgkin lymphoma
T2 - a nationwide population-based study in the Netherlands, 1989–2017
AU - Driessen, Julia
AU - Visser, Otto
AU - Zijlstra, Josée M.
AU - Lugtenburg, Pieternella J.
AU - Plattel, Wouter J.
AU - Kersten, Marie José
AU - Dinmohamed, Avinash G.
N1 - Funding Information: Acknowledgements The authors would like to thank the registration clerks of the Netherlands Cancer Registry (NCR) for their dedicated data collection. The nationwide population-based NCR is maintained and hosted by the Netherlands Comprehensive Cancer Organisation (IKNL). This work was supported by research funding from Stichting SHOW (grant to Julia Driessen). Publisher Copyright: © 2020, The Author(s), under exclusive licence to Springer Nature Limited. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Population-based studies of classical Hodgkin lymphoma (cHL) in contemporary clinical practice are scarce. The aim of this nationwide population-based study is to assess trends in primary therapy and relative survival (RS) during 1989–2017. We included 9,985 patients with cHL. Radiotherapy alone was virtually not applied as from 2000 among patients aged 18–69 years with stage I/II disease, following the broader application of chemotherapy combined with radiotherapy. Chemotherapy only was the preferred treatment for patients with stage III/IV disease. Throughout the entire study period, around 20% of patients aged ≥70 years across all disease stages received no anti-neoplastic therapy. The most considerable improvements in 5-year RS were confined to patients aged 18–59 years. Five-year RS for patients with stage I/II disease diagnosed during 2010–2017 was 99%, 98%, 100%, 93%, 84%, and 61% for patients aged 18–29, 30–39, 40–49, 50–59, 60–69, and ≥70 years, respectively. The corresponding estimates for stage III/IV disease were 96%, 92%, 90%, 80%, 58%, and 46%. Collectively, the improvements in survival likely relate to advances in cHL management. These achievements, however, do not seem to translate into significant benefits for patients ≥60 years. Therefore, novel therapies are urgently needed to reduce excess mortality in elderly cHL patients.
AB - Population-based studies of classical Hodgkin lymphoma (cHL) in contemporary clinical practice are scarce. The aim of this nationwide population-based study is to assess trends in primary therapy and relative survival (RS) during 1989–2017. We included 9,985 patients with cHL. Radiotherapy alone was virtually not applied as from 2000 among patients aged 18–69 years with stage I/II disease, following the broader application of chemotherapy combined with radiotherapy. Chemotherapy only was the preferred treatment for patients with stage III/IV disease. Throughout the entire study period, around 20% of patients aged ≥70 years across all disease stages received no anti-neoplastic therapy. The most considerable improvements in 5-year RS were confined to patients aged 18–59 years. Five-year RS for patients with stage I/II disease diagnosed during 2010–2017 was 99%, 98%, 100%, 93%, 84%, and 61% for patients aged 18–29, 30–39, 40–49, 50–59, 60–69, and ≥70 years, respectively. The corresponding estimates for stage III/IV disease were 96%, 92%, 90%, 80%, 58%, and 46%. Collectively, the improvements in survival likely relate to advances in cHL management. These achievements, however, do not seem to translate into significant benefits for patients ≥60 years. Therefore, novel therapies are urgently needed to reduce excess mortality in elderly cHL patients.
UR - http://www.scopus.com/inward/record.url?scp=85085491843&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41375-020-0875-0
DO - https://doi.org/10.1038/s41375-020-0875-0
M3 - Article
C2 - 32461630
SN - 0887-6924
VL - 35
SP - 494
EP - 505
JO - Leukemia
JF - Leukemia
IS - 2
ER -