Low-Dose Radiation Is Sufficient for the Noninvolved Extended-Field Treatment in Favorable Early-Stage Hodgkin’s Disease: Long-Term Results of a Randomized Trial of Radiotherapy Alone
To show that radiotherapy (RT) dose to the noninvolved extended field (EF) can be reduced without loss of efficacy in patients with early-stage Hodgkin's disease (HD). During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal...
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| Veröffentlicht in: | Journal of clinical oncology 2001-06, Vol.19 (11), p.2905-2914 |
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| creator | DÜHMKE, Eckhart FRANKLIN, Jeremy LATHAN, Bernd RÜFFER, Ulrich SIEBER, Markus WOLF, Jürgen ENGERT, Andreas GEORGII, Axel STAAR, Susanne HERRMANN, Richard BEYKIRCH, Maria KIRCHNER, Hartmut PFREUNDSCHUH, Michael EMMINGER, Adelheid GREIL, Richard FRITSCH, Esther KOCH, Peter DROCHTERT, Angelika BROSTEANU, Oana HASENCLEVER, Dirk LOEFFLER, Markus DIEHL, Volker SEHLEN, Susanne WILLICH, Norman RÜHL, Ursula MÜLLER, Rolf-Peter LUKAS, Peter ATZINGER, Anton PAULUS, Ursula |
| description | To show that radiotherapy (RT) dose to the noninvolved extended field (EF) can be reduced without loss of efficacy in patients with early-stage Hodgkin's disease (HD).
During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal mass, extranodal lesions, massive splenic disease, elevated erythrocyte sedimentation rate, or three or more involved areas) were recruited from various centers. All patients received 40 Gy total fractionated dose to the involved field areas but were randomly assigned to receive either 40 Gy (arm A) or 30 Gy (arm B) total fractionated dose for the clinically noninvolved EF. No chemotherapy was given. RT films were prospectively reviewed for protocol violations and recurrences retrospectively related to the applied RT.
Of 382 recruited patients, 376 were eligible for randomized comparison, 190 in arm A and 186 in arm B. Complete remission was attained in 98% of patients in each arm. With a median follow-up of 86 months, 7-year relapse-free survival (RFS) rates were 78% (arm A) and 83% (arm B) (P =.093). The upper 95% confidence limit for the possible inferiority of arm B in RFS was 4%. Corresponding overall survival rates were 91% (arm A) and 96% (arm B) (P =.16). The most common causes of death (n = 27) were cardiorespiratory disease/pulmonary embolisms (seven), second malignancy (six), and HD (five). Protocol violation was associated with significantly poorer RFS. Nonirradiated nodes were involved in 42 of 52 reviewed relapses, infield areas in 18, marginal areas in 17, and extranodal sites in 16.
EF-RT alone attains good survival rates in favorable early-stage HD. The 30-Gy dose is adequate for clinically noninvolved areas. Protocol violation worsens the subsequent prognosis. Relapse patterns suggest that systemic therapy can reduce the 20% long-term relapse rate. |
| doi_str_mv | 10.1200/jco.2001.19.11.2905 |
| format | Article |
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During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal mass, extranodal lesions, massive splenic disease, elevated erythrocyte sedimentation rate, or three or more involved areas) were recruited from various centers. All patients received 40 Gy total fractionated dose to the involved field areas but were randomly assigned to receive either 40 Gy (arm A) or 30 Gy (arm B) total fractionated dose for the clinically noninvolved EF. No chemotherapy was given. RT films were prospectively reviewed for protocol violations and recurrences retrospectively related to the applied RT.
Of 382 recruited patients, 376 were eligible for randomized comparison, 190 in arm A and 186 in arm B. Complete remission was attained in 98% of patients in each arm. With a median follow-up of 86 months, 7-year relapse-free survival (RFS) rates were 78% (arm A) and 83% (arm B) (P =.093). The upper 95% confidence limit for the possible inferiority of arm B in RFS was 4%. Corresponding overall survival rates were 91% (arm A) and 96% (arm B) (P =.16). The most common causes of death (n = 27) were cardiorespiratory disease/pulmonary embolisms (seven), second malignancy (six), and HD (five). Protocol violation was associated with significantly poorer RFS. Nonirradiated nodes were involved in 42 of 52 reviewed relapses, infield areas in 18, marginal areas in 17, and extranodal sites in 16.
EF-RT alone attains good survival rates in favorable early-stage HD. The 30-Gy dose is adequate for clinically noninvolved areas. Protocol violation worsens the subsequent prognosis. Relapse patterns suggest that systemic therapy can reduce the 20% long-term relapse rate.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/jco.2001.19.11.2905</identifier><identifier>PMID: 11387364</identifier><language>eng</language><publisher>Baltimore, MD: American Society of Clinical Oncology</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Dose Fractionation ; Female ; Hemopathies ; Hodgkin Disease - pathology ; Hodgkin Disease - radiotherapy ; Humans ; Male ; Medical sciences ; Middle Aged ; Patient Compliance ; Prognosis ; Radiotherapy - methods ; Radiotherapy Dosage ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Survival Analysis ; Treatment Outcome</subject><ispartof>Journal of clinical oncology, 2001-06, Vol.19 (11), p.2905-2914</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-9ef7ee712460e2a17f65d8e7e2824b9d01a5e2a38655f75f80fff3b8621d29b93</citedby><cites>FETCH-LOGICAL-c428t-9ef7ee712460e2a17f65d8e7e2824b9d01a5e2a38655f75f80fff3b8621d29b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1097909$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11387364$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DÜHMKE, Eckhart</creatorcontrib><creatorcontrib>FRANKLIN, Jeremy</creatorcontrib><creatorcontrib>LATHAN, Bernd</creatorcontrib><creatorcontrib>RÜFFER, Ulrich</creatorcontrib><creatorcontrib>SIEBER, Markus</creatorcontrib><creatorcontrib>WOLF, Jürgen</creatorcontrib><creatorcontrib>ENGERT, Andreas</creatorcontrib><creatorcontrib>GEORGII, Axel</creatorcontrib><creatorcontrib>STAAR, Susanne</creatorcontrib><creatorcontrib>HERRMANN, Richard</creatorcontrib><creatorcontrib>BEYKIRCH, Maria</creatorcontrib><creatorcontrib>KIRCHNER, Hartmut</creatorcontrib><creatorcontrib>PFREUNDSCHUH, Michael</creatorcontrib><creatorcontrib>EMMINGER, Adelheid</creatorcontrib><creatorcontrib>GREIL, Richard</creatorcontrib><creatorcontrib>FRITSCH, Esther</creatorcontrib><creatorcontrib>KOCH, Peter</creatorcontrib><creatorcontrib>DROCHTERT, Angelika</creatorcontrib><creatorcontrib>BROSTEANU, Oana</creatorcontrib><creatorcontrib>HASENCLEVER, Dirk</creatorcontrib><creatorcontrib>LOEFFLER, Markus</creatorcontrib><creatorcontrib>DIEHL, Volker</creatorcontrib><creatorcontrib>SEHLEN, Susanne</creatorcontrib><creatorcontrib>WILLICH, Norman</creatorcontrib><creatorcontrib>RÜHL, Ursula</creatorcontrib><creatorcontrib>MÜLLER, Rolf-Peter</creatorcontrib><creatorcontrib>LUKAS, Peter</creatorcontrib><creatorcontrib>ATZINGER, Anton</creatorcontrib><creatorcontrib>PAULUS, Ursula</creatorcontrib><title>Low-Dose Radiation Is Sufficient for the Noninvolved Extended-Field Treatment in Favorable Early-Stage Hodgkin’s Disease: Long-Term Results of a Randomized Trial of Radiotherapy Alone</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>To show that radiotherapy (RT) dose to the noninvolved extended field (EF) can be reduced without loss of efficacy in patients with early-stage Hodgkin's disease (HD).
During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal mass, extranodal lesions, massive splenic disease, elevated erythrocyte sedimentation rate, or three or more involved areas) were recruited from various centers. All patients received 40 Gy total fractionated dose to the involved field areas but were randomly assigned to receive either 40 Gy (arm A) or 30 Gy (arm B) total fractionated dose for the clinically noninvolved EF. No chemotherapy was given. RT films were prospectively reviewed for protocol violations and recurrences retrospectively related to the applied RT.
Of 382 recruited patients, 376 were eligible for randomized comparison, 190 in arm A and 186 in arm B. Complete remission was attained in 98% of patients in each arm. With a median follow-up of 86 months, 7-year relapse-free survival (RFS) rates were 78% (arm A) and 83% (arm B) (P =.093). The upper 95% confidence limit for the possible inferiority of arm B in RFS was 4%. Corresponding overall survival rates were 91% (arm A) and 96% (arm B) (P =.16). The most common causes of death (n = 27) were cardiorespiratory disease/pulmonary embolisms (seven), second malignancy (six), and HD (five). Protocol violation was associated with significantly poorer RFS. Nonirradiated nodes were involved in 42 of 52 reviewed relapses, infield areas in 18, marginal areas in 17, and extranodal sites in 16.
EF-RT alone attains good survival rates in favorable early-stage HD. The 30-Gy dose is adequate for clinically noninvolved areas. Protocol violation worsens the subsequent prognosis. Relapse patterns suggest that systemic therapy can reduce the 20% long-term relapse rate.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Dose Fractionation</subject><subject>Female</subject><subject>Hemopathies</subject><subject>Hodgkin Disease - pathology</subject><subject>Hodgkin Disease - radiotherapy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Compliance</subject><subject>Prognosis</subject><subject>Radiotherapy - methods</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNks1uEzEURkcIREPhCZCQFwhWE2zPjz3sqjRpiyIqtUFiZ3nG14mLx07tmZR0xWvwKLwOT8KMEomurnR17vEnfU6StwRPCcX4013jp8MkU1JNCZnSChfPkgkpKEsZK4rnyQSzjKaEZ99Pklcx3g1szrPiZXJCSMZZVuaT5M_SP6TnPgK6kcrIzniHriK67bU2jQHXIe0D6jaAvnpn3M7bHSg0_9mBU6DShQGr0CqA7NoRNg4t5M4HWVtAcxnsPr3t5BrQpVfrH8b9_fU7onMTQUb4jJberdMVhBbdQOxtF5HXSA5JnPKteYTRbKQdt2M6P8QIcrtHZ9Y7eJ280NJGeHOcp8m3xXw1u0yX1xdXs7Nl2uSUd2kFmgEwQvMSA5WE6bJQHBhQTvO6UpjIYthnvCwKzQrNsdY6q3lJiaJVXWWnyYeDdxv8fQ-xE62JDVgrHfg-CoY5rygtBzA7gE3wMQbQYhtMK8NeECzGxsSX2bUYGxOkEoSIsbHh6t1R39ctqP83x4oG4P0RkLGRVgfpGhOfuCtW4THmxwO2MevNgwkgYiutHaxUDD_lyYv_ABOar2E</recordid><startdate>20010601</startdate><enddate>20010601</enddate><creator>DÜHMKE, Eckhart</creator><creator>FRANKLIN, Jeremy</creator><creator>LATHAN, Bernd</creator><creator>RÜFFER, Ulrich</creator><creator>SIEBER, Markus</creator><creator>WOLF, Jürgen</creator><creator>ENGERT, Andreas</creator><creator>GEORGII, Axel</creator><creator>STAAR, Susanne</creator><creator>HERRMANN, Richard</creator><creator>BEYKIRCH, Maria</creator><creator>KIRCHNER, Hartmut</creator><creator>PFREUNDSCHUH, Michael</creator><creator>EMMINGER, Adelheid</creator><creator>GREIL, Richard</creator><creator>FRITSCH, Esther</creator><creator>KOCH, Peter</creator><creator>DROCHTERT, Angelika</creator><creator>BROSTEANU, Oana</creator><creator>HASENCLEVER, Dirk</creator><creator>LOEFFLER, Markus</creator><creator>DIEHL, Volker</creator><creator>SEHLEN, Susanne</creator><creator>WILLICH, Norman</creator><creator>RÜHL, Ursula</creator><creator>MÜLLER, Rolf-Peter</creator><creator>LUKAS, Peter</creator><creator>ATZINGER, Anton</creator><creator>PAULUS, Ursula</creator><general>American Society of Clinical Oncology</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010601</creationdate><title>Low-Dose Radiation Is Sufficient for the Noninvolved Extended-Field Treatment in Favorable Early-Stage Hodgkin’s Disease: Long-Term Results of a Randomized Trial of Radiotherapy Alone</title><author>DÜHMKE, Eckhart ; FRANKLIN, Jeremy ; LATHAN, Bernd ; RÜFFER, Ulrich ; SIEBER, Markus ; WOLF, Jürgen ; ENGERT, Andreas ; GEORGII, Axel ; STAAR, Susanne ; HERRMANN, Richard ; BEYKIRCH, Maria ; KIRCHNER, Hartmut ; PFREUNDSCHUH, Michael ; EMMINGER, Adelheid ; GREIL, Richard ; FRITSCH, Esther ; KOCH, Peter ; DROCHTERT, Angelika ; BROSTEANU, Oana ; HASENCLEVER, Dirk ; LOEFFLER, Markus ; DIEHL, Volker ; SEHLEN, Susanne ; WILLICH, Norman ; RÜHL, Ursula ; MÜLLER, Rolf-Peter ; LUKAS, Peter ; ATZINGER, Anton ; PAULUS, Ursula</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-9ef7ee712460e2a17f65d8e7e2824b9d01a5e2a38655f75f80fff3b8621d29b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Dose Fractionation</topic><topic>Female</topic><topic>Hemopathies</topic><topic>Hodgkin Disease - pathology</topic><topic>Hodgkin Disease - radiotherapy</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Compliance</topic><topic>Prognosis</topic><topic>Radiotherapy - methods</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy. 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Diet therapy and various other treatments (general aspects)</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DÜHMKE, Eckhart</creatorcontrib><creatorcontrib>FRANKLIN, Jeremy</creatorcontrib><creatorcontrib>LATHAN, Bernd</creatorcontrib><creatorcontrib>RÜFFER, Ulrich</creatorcontrib><creatorcontrib>SIEBER, Markus</creatorcontrib><creatorcontrib>WOLF, Jürgen</creatorcontrib><creatorcontrib>ENGERT, Andreas</creatorcontrib><creatorcontrib>GEORGII, Axel</creatorcontrib><creatorcontrib>STAAR, Susanne</creatorcontrib><creatorcontrib>HERRMANN, Richard</creatorcontrib><creatorcontrib>BEYKIRCH, Maria</creatorcontrib><creatorcontrib>KIRCHNER, Hartmut</creatorcontrib><creatorcontrib>PFREUNDSCHUH, Michael</creatorcontrib><creatorcontrib>EMMINGER, Adelheid</creatorcontrib><creatorcontrib>GREIL, Richard</creatorcontrib><creatorcontrib>FRITSCH, Esther</creatorcontrib><creatorcontrib>KOCH, Peter</creatorcontrib><creatorcontrib>DROCHTERT, Angelika</creatorcontrib><creatorcontrib>BROSTEANU, Oana</creatorcontrib><creatorcontrib>HASENCLEVER, Dirk</creatorcontrib><creatorcontrib>LOEFFLER, Markus</creatorcontrib><creatorcontrib>DIEHL, Volker</creatorcontrib><creatorcontrib>SEHLEN, Susanne</creatorcontrib><creatorcontrib>WILLICH, Norman</creatorcontrib><creatorcontrib>RÜHL, Ursula</creatorcontrib><creatorcontrib>MÜLLER, Rolf-Peter</creatorcontrib><creatorcontrib>LUKAS, Peter</creatorcontrib><creatorcontrib>ATZINGER, Anton</creatorcontrib><creatorcontrib>PAULUS, Ursula</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DÜHMKE, Eckhart</au><au>FRANKLIN, Jeremy</au><au>LATHAN, Bernd</au><au>RÜFFER, Ulrich</au><au>SIEBER, Markus</au><au>WOLF, Jürgen</au><au>ENGERT, Andreas</au><au>GEORGII, Axel</au><au>STAAR, Susanne</au><au>HERRMANN, Richard</au><au>BEYKIRCH, Maria</au><au>KIRCHNER, Hartmut</au><au>PFREUNDSCHUH, Michael</au><au>EMMINGER, Adelheid</au><au>GREIL, Richard</au><au>FRITSCH, Esther</au><au>KOCH, Peter</au><au>DROCHTERT, Angelika</au><au>BROSTEANU, Oana</au><au>HASENCLEVER, Dirk</au><au>LOEFFLER, Markus</au><au>DIEHL, Volker</au><au>SEHLEN, Susanne</au><au>WILLICH, Norman</au><au>RÜHL, Ursula</au><au>MÜLLER, Rolf-Peter</au><au>LUKAS, Peter</au><au>ATZINGER, Anton</au><au>PAULUS, Ursula</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low-Dose Radiation Is Sufficient for the Noninvolved Extended-Field Treatment in Favorable Early-Stage Hodgkin’s Disease: Long-Term Results of a Randomized Trial of Radiotherapy Alone</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2001-06-01</date><risdate>2001</risdate><volume>19</volume><issue>11</issue><spage>2905</spage><epage>2914</epage><pages>2905-2914</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>To show that radiotherapy (RT) dose to the noninvolved extended field (EF) can be reduced without loss of efficacy in patients with early-stage Hodgkin's disease (HD).
During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal mass, extranodal lesions, massive splenic disease, elevated erythrocyte sedimentation rate, or three or more involved areas) were recruited from various centers. All patients received 40 Gy total fractionated dose to the involved field areas but were randomly assigned to receive either 40 Gy (arm A) or 30 Gy (arm B) total fractionated dose for the clinically noninvolved EF. No chemotherapy was given. RT films were prospectively reviewed for protocol violations and recurrences retrospectively related to the applied RT.
Of 382 recruited patients, 376 were eligible for randomized comparison, 190 in arm A and 186 in arm B. Complete remission was attained in 98% of patients in each arm. With a median follow-up of 86 months, 7-year relapse-free survival (RFS) rates were 78% (arm A) and 83% (arm B) (P =.093). The upper 95% confidence limit for the possible inferiority of arm B in RFS was 4%. Corresponding overall survival rates were 91% (arm A) and 96% (arm B) (P =.16). The most common causes of death (n = 27) were cardiorespiratory disease/pulmonary embolisms (seven), second malignancy (six), and HD (five). Protocol violation was associated with significantly poorer RFS. Nonirradiated nodes were involved in 42 of 52 reviewed relapses, infield areas in 18, marginal areas in 17, and extranodal sites in 16.
EF-RT alone attains good survival rates in favorable early-stage HD. The 30-Gy dose is adequate for clinically noninvolved areas. Protocol violation worsens the subsequent prognosis. Relapse patterns suggest that systemic therapy can reduce the 20% long-term relapse rate.</abstract><cop>Baltimore, MD</cop><pub>American Society of Clinical Oncology</pub><pmid>11387364</pmid><doi>10.1200/jco.2001.19.11.2905</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0732-183X |
| ispartof | Journal of clinical oncology, 2001-06, Vol.19 (11), p.2905-2914 |
| issn | 0732-183X 1527-7755 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70889226 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adolescent Adult Aged Biological and medical sciences Dose Fractionation Female Hemopathies Hodgkin Disease - pathology Hodgkin Disease - radiotherapy Humans Male Medical sciences Middle Aged Patient Compliance Prognosis Radiotherapy - methods Radiotherapy Dosage Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Survival Analysis Treatment Outcome |
| title | Low-Dose Radiation Is Sufficient for the Noninvolved Extended-Field Treatment in Favorable Early-Stage Hodgkin’s Disease: Long-Term Results of a Randomized Trial of Radiotherapy Alone |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T06%3A45%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Low-Dose%20Radiation%20Is%20Sufficient%20for%20the%20Noninvolved%20Extended-Field%20Treatment%20in%20Favorable%20Early-Stage%20Hodgkin%E2%80%99s%20Disease:%20Long-Term%20Results%20of%20a%20Randomized%20Trial%20of%20Radiotherapy%20Alone&rft.jtitle=Journal%20of%20clinical%20oncology&rft.au=D%C3%9CHMKE,%20Eckhart&rft.date=2001-06-01&rft.volume=19&rft.issue=11&rft.spage=2905&rft.epage=2914&rft.pages=2905-2914&rft.issn=0732-183X&rft.eissn=1527-7755&rft_id=info:doi/10.1200/jco.2001.19.11.2905&rft_dat=%3Cproquest_cross%3E70889226%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=70889226&rft_id=info:pmid/11387364&rfr_iscdi=true |