Patients with early-​​stage Hodgkin lym­phoma who were treated with mul­tidrug chemother­apy were more likely to be alive 12 years after treat­ment than patients who received the same chemother­apy plus radi­a­tion, accord­ing to a new study. More of the patients who received radi­a­tion ther­apy died from sec­ond can­cers or other toxic late effects of their treat­ment, such as heart dis­ease, than those who received chemother­apy alone, accord­ing to the researchers.

The over­all sur­vival rate was 94% for patients treated with the drugs dox­oru­bicin, bleomycin, vin­blas­tine, and dacar­bazine (ABVD reg­i­men), com­pared with 87% for patients who received either radi­a­tion ther­apy alone or ABVD plus radi­a­tion ther­apy. Of the 405 peo­ple enrolled in the study, 12 in the ABVD alone group died dur­ing the follow-​​up period (six from Hodgkin lym­phoma, four from sec­ond can­cers, and two from other causes). In con­trast, 24 patients in the group receiv­ing radi­a­tion died (4 from Hodgkin lym­phoma, 10 from sec­ond can­cers, and 10 from other causes). All of the study’s par­tic­i­pants had stage IA or IIA Hodgkin lym­phoma with tumors smaller than four inches in diameter.

The type of radi­a­tion ther­apy used in the study, known as subto­tal nodal radi­a­tion ther­apy, is now con­sid­ered out­dated. How­ever, accord­ing to the researchers, although the risks of late effects asso­ci­ated with radi­a­tion ther­apy are likely reduced with mod­ern strate­gies, the mag­ni­tude by which they are reduced isn’t known.

• Meyer, R.M., Gospo­darow­icz, M.K., Con­nors, J.M., Pearcey, R.G., Wells, W.A., Win­ter, J.N., . . . Shep­herd, L.E. (2011). ABVD alone ver­sus radiation-​​based ther­apy in lim­ited stage Hodgkin’s lym­phoma. New Eng­land Jour­nal of Med­i­cine. [Epub ahead of print]