Cochrane · systematic review · CD008814
Optimisation of chemotherapy and radiotherapy for untreated Hodgkin lymphoma patients with respect to second malignant neoplasms, overall and progression‐free survival: individual participant data analysis
Franklin, J, Eichenauer, DA, Becker, I, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
HaematologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
15
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 4 · 26.7%Moderate 5 · 33.3%High 6 · 40%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Chemotherapy alone versus same chemotherapy plus radiotherapy
Population: Patients with untreated Hodgkin lymphoma (early and advanced stages)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary malignant neoplasms Chemotherapy alone vs same chemotherapy plus radiotherapy | OR 0.43 [0.23, 0.82] | 3 studies · 1011 participants | Low Downgraded: imprecision |
Death Chemotherapy alone vs same chemotherapy plus radiotherapy | HR 0.71 [0.46, 1.11] | 3 studies · 1011 participants | Moderate Downgraded: imprecision |
Progression/relapse Chemotherapy alone vs same chemotherapy plus radiotherapy | HR 1.31 [0.99, 1.73] | 3 studies · 1011 participants | Moderate Downgraded: inconsistency |
Chemotherapy plus involved‐field radiation versus same chemotherapy plus extended‐field radiation
Population: Patients with untreated Hodgkin lymphoma (early stages)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary malignant neoplasms Chemotherapy plus involved‐field radiation vs same chemotherapy plus extended‐field radiation | OR 0.86 [0.64, 1.16] | 4 studies · 2397 participants | Low Downgraded: inconsistency |
Death Chemotherapy plus involved‐field radiation vs same chemotherapy plus extended‐field radiation | HR 0.89 [0.7, 1.12] | 4 studies · 2397 participants | High |
Progression/relapse Chemotherapy plus involved‐field radiation vs same chemotherapy plus extended‐field radiation | HR 0.99 [0.81, 1.21] | 4 studies · 2397 participants | High |
Chemotherapy plus lower‐dose radiation versus same chemotherapy plus higher‐dose radiation
Population: Patients with untreated Hodgkin lymphoma (early stages)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary malignant neoplasms Chemotherapy plus lower‐dose radiation vs same chemotherapy plus higher‐dose radiation | OR 1.03 [0.71, 1.5] | 3 studies · 2962 participants | Low Downgraded: inconsistency |
Death Chemotherapy plus lower‐dose radiation vs same chemotherapy plus higher‐dose radiation | HR 0.91 [0.65, 1.28] | 3 studies · 2962 participants | High |
Progression/relapse Chemotherapy plus lower‐dose radiation vs same chemotherapy plus higher‐dose radiation | HR 1.2 [0.97, 1.48] | 3 studies · 2962 participants | High |
Fewer versus more courses of chemotherapy (with or without radiotherapy in each case)
Population: Patients with untreated Hodgkin lymphoma (early stages)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary malignant neoplasms Fewer vs more courses of chemotherapy (with or without radiotherapy | OR 1.1 [0.74, 1.62] | 3 studies · 2403 participants | Moderate |
Death Fewer vs more courses of chemotherapy (with or without radiotherapy | HR 0.99 [0.73, 1.34] | 3 studies · 2403 participants | High |
Progression/relapse Fewer vs more courses of chemotherapy (with or without radiotherapy | HR 1.15 [0.91, 1.45] | 3 studies · 2403 participants | High |
Dose‐intensified chemotherapy versus ABVD‐like chemotherapy (with or without radiotherapy in each case)
Population: Patients with untreated Hodgkin lymphoma (advanced stages)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Secondary malignant neoplasms Dose‐intensified chemotherapy vs ABVD‐like chemotherapy (with or without radiotherapy | OR 1.37 [0.89, 2.1] | 7 studies · 2996 participants | Low Downgraded: imprecision |
Death Dose‐intensified chemotherapy vs ABVD‐like chemotherapy (with or without radiotherapy | HR 0.85 [0.7, 1.04] | 7 studies · 2996 participants | Moderate Downgraded: inconsistency |
Progression/relapse Dose‐intensified chemotherapy vs ABVD‐like chemotherapy (with or without radiotherapy | HR 0.82 [0.7, 0.95] | 7 studies · 2996 participants | Moderate Downgraded: inconsistency |