The Effect of Diagnostic and Therapeutic Changes on the Survival of Hodgkin’s Lymphoma Patients (1980–2019)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Staging and Response Assessment
2.2. Chemotherapy
2.3. Radiotherapy
2.4. Other Treatments
2.5. Statistical Methods and Outcome Analysis
3. Results
3.1. Clinical and Treatment Characteristics
3.2. Overall and Progression-Free Survival
4. Discussion
4.1. Stage Migration
4.2. Change in Treatment Approach
4.3. Changing of the Survival Results
4.3.1. Overall Survival
4.3.2. Progression-Free Survival
4.4. Predictors of Survival
4.5. Future Therapies
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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1980–1989 | 1990–1999 | 2000–2009 | 2010–2019 | ||
---|---|---|---|---|---|
Patients | 192 | 199 | 226 | 159 | |
Gender | |||||
Male | 108 | 109 | 115 | 77 | p = 0.100 |
Female | 84 | 90 | 111 | 82 | |
Stage | |||||
I | 11 | 9 | 22 | 5 | p < 0.001 |
II | 50 | 45 | 97 | 55 | |
III | 97 | 96 | 52 | 24 | |
IV | 27 | 32 | 51 | 75 | |
Early stages | 61 | 54 | 119 | 60 | p = 0.008 |
Advanced stages | 124 | 128 | 104 | 99 | |
B signs | 95 | 87 | 114 | 88 | p = 0.134 |
Treatment | |||||
radiotherapy alone | 53 | 16 | 2 | 0 | p < 0.001 |
chemotherapy alone | 84 | 88 | 108 | 119 | |
combined chemo- and radiotherapy | 23 | 77 | 115 | 40 | |
Follow-up | |||||
alive | 21 | 84 | 166 | 137 | p < 0.001 |
death | 170 | 114 | 59 | 21 | |
lost to follow-up | 1 | 1 | 1 | 1 | |
Remain in remission | 134 | 134 | 163 | 114 | p < 0.001 |
Relapse | 48 | 58 | 30 | 14 | |
Refractory (progression within 3 months after first-line treatment) | 10 | 7 | 33 | 31 |
All Patients | |||||
---|---|---|---|---|---|
Univariate | Multivariate | ||||
HR (95% CI) | p | HR (95% CI) | p | ||
OS | |||||
Gender (vs. male) | |||||
Female | 0.784 (0.545–1.129) | 0.191 | |||
Time of diagnosis (vs. 1990–1999) | |||||
2000–2009 | 0.910 (0.614–1.347) | 0.637 | |||
2010–2019 | 0.536 (0.314–0.913) | 0.022 | 0.405 (0.258–0.787) | 0.005 | |
Stage (vs. early) | |||||
Advanced | 1.437 (0.979–2.110) | 0.064 | |||
B-symptoms (vs. absent) | |||||
Present | 1.708 (1.182–2.466) | 0.004 | 1.804 (1.222–2.662) | 0.003 | |
Treatment (vs. CMT) | |||||
RT | 2.397 (0.932–6.164) | 0.07 | |||
CT | 2.125 (1.398–3.229) | <0.001 | 2.284 (1.496–3.488) | <0.001 | |
PFS | |||||
Gender (vs. male) | |||||
Female | 0.893 (0.688–1.159) | 0.395 | |||
Time of diagnosis (vs. 1990–1999) | |||||
2000–2009 | 0.973 (0.724–1.306) | 0.853 | |||
2010–2019 | 0.858 (0.607–1.213) | 0.386 | |||
Stage (vs. early) | |||||
Advanced | 1.828 (1.375–2.432) | <0.001 | 1.592 (1.166–2.175) | 0.003 | |
B-symptoms (vs. absent) | |||||
Present | 1.422 (1.096–1.846) | 0.008 | 1.310 (0.986–1.739) | 0.062 | |
Treatment (vs. CMT) | |||||
RT | 1.757 (1.317–2.345) | <0.001 | 2.968 (1.515–5.815) | 0.003 | |
CT | 2.427 (1.284–4.587) | 0.006 | 1.602 (1.176–2.184) | 0.002 |
1990–1999 | 2000–2009 | 2010–2019 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | Univariate | Multivariate | ||||||||
HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | ||
OS | |||||||||||||
Gender (vs. male) | |||||||||||||
Female | 0.526 (0.286–0.969) | 0.039 | 0.556 (0.302–1.026) | 0.06 | 1.039 (0.603–1.790) | 0.891 | 1.066 (0.433–2.623) | 0.890 | |||||
Stage (vs. early) | |||||||||||||
Advanced | 0.949 (0.512–1.758) | 0.868 | 1.643 (0.937–2.881) | 0.083 | 2.511 (0.833–7.572) | 0.102 | |||||||
B-symptoms (vs. absent) | |||||||||||||
Present | 2.342 (1.313–4.179) | 0.004 | 2.254 (1.262–4.026) | 0.006 | 1.349 (0.778–2.339) | 0.286 | 0.216 | ||||||
Treatment (vs. CMT) | |||||||||||||
RT | 2.033 (0.732–5.647) | 0.173 | 0 (0–>10) | 0.976 | |||||||||
CT | 1.678 (0.863–3.261) | 0.127 | 2.607 (1.443–4.712) | 0.002 | 6.912 (0.919–51.987) | 0.06 | |||||||
PFS | |||||||||||||
Gender (vs. male) | |||||||||||||
Female | 0.718 (0.461–1.119) | 0.143 | 0.962 (0.640–1.445) | 0.850 | 1.104 (0.640–1.905) | 0.722 | |||||||
Stage (vs. early) | |||||||||||||
Advanced | 1.139 (0.700–1.853) | 0.601 | 2.501 (1.622–3.856) | <0.001 | 2.004 (1.244–3.227) | 0.004 | 1.890 (1.024–3.491) | 0.042 | 1.440 (0.756–2.744) | 0.268 | |||
B-symptoms (vs. absent) | |||||||||||||
Present | 1.670 (1.088–2.563) | 0.019 | 1.977 (1.245–3.203) | 0.004 | 1.564 (1.034–2.366) | 0.034 | 1.302 (0.838–2.025) | 0.241 | 1.055 (0.610–1.823) | 0.849 | |||
Treatment (vs. CMT) | |||||||||||||
RT | 2.477 (1.231–4.983) | 0.011 | 3.283 (1.577–6.833) | 0.001 | 0 (0–>10) | 0.965 | |||||||
CT | 1.331 (0.817–2.170) | 0.251 | 1.963 (1.288–2.992) | 0.002 | 1.583 (1.003–2.497) | 0.048 | 2.972 (1.267–6.970) | 0.012 | 2.536 (1.035–6.214) | 0.042 |
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Illés, Á.; Dobó, B.; Borics, F.; Tóthfalusi, D.; Pinczés, L.I.; Miltényi, Z. The Effect of Diagnostic and Therapeutic Changes on the Survival of Hodgkin’s Lymphoma Patients (1980–2019). Medicina 2024, 60, 1272. https://doi.org/10.3390/medicina60081272
Illés Á, Dobó B, Borics F, Tóthfalusi D, Pinczés LI, Miltényi Z. The Effect of Diagnostic and Therapeutic Changes on the Survival of Hodgkin’s Lymphoma Patients (1980–2019). Medicina. 2024; 60(8):1272. https://doi.org/10.3390/medicina60081272
Chicago/Turabian StyleIllés, Árpád, Boglárka Dobó, Fanni Borics, Dávid Tóthfalusi, László Imre Pinczés, and Zsófia Miltényi. 2024. "The Effect of Diagnostic and Therapeutic Changes on the Survival of Hodgkin’s Lymphoma Patients (1980–2019)" Medicina 60, no. 8: 1272. https://doi.org/10.3390/medicina60081272