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43

NCCN Guidelines for Patients

®

Hodgkin Lymphoma, Version 1.2015

Chart 4.1.9

maps a third treatment path for some large

harder-to-treat stage I or II cancers. This path includes

intense treatment that is likely to be hard on your body.

Thus, you should be younger than 60 years old.

There are two pathways in this chart. The top

pathway is for cancers without B symptoms and

E tumors. The bottom pathway is for cancers with B

symptoms or E tumors. B symptoms include fevers,

night sweats, and weight loss. E tumors are found in

tissue other than lymph nodes (extranodal).

Treatment in the top pathway starts with 2 cycles

of BEACOPP and 2 cycles of ABVD. Next, radiation

therapy can be received if treatment results are good.

If results look poor but no cancer is found by biopsy,

radiation therapy is advised. If cancer is found, read

Part 4.3 to learn which treatments you can receive next.

Treatment in the bottom pathway starts with 6 cycles

of BEACOPP. After chemotherapy, treatment results

should be tested. If chemotherapy appears to have

cured the cancer, you can start follow-up care.

Read Part 4.5 for more information. If chemotherapy

appears to be working less well, you can receive

radiation therapy.

When treatment results appear to be poor, a biopsy

is needed. If no cancer is found, you can either start

follow-up care or receive radiation therapy. If cancer

is found, read Part 4.3 to learn which treatments you

can receive next.

Chart 4.1.9 Option 3 if younger than 60 years

Treatment

Test results

Treatment

2 cycles of BEACOPP

with 2 cycles of ABVD

for cancers without

B symptoms and E

tumors

Treatment appears to be working

Radiation therapy

Treatment may be working poorly;

No cancer is found with biopsy

Radiation therapy

More cancer drugs

Treatment may be working poorly;

Cancer is found with biopsy

More cancer drugs

Treatment may be working poorly;

Cancer is found with biopsy

Radiation therapy

Treatment appears to be working

less than wanted

6 cycles of BEACOPP

for cancers with

B symptoms or

E tumors

Treatment appears to be working well

Start follow-up care

Start follow-up care

Treatment may be working poorly;

No cancer is found with biopsy

Radiation therapy

4

Treatment guide: Classical Hodgkin lymphoma Stages I and II treatment