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45

NCCN Guidelines for Patients

®

Hodgkin Lymphoma, Version 1.2015

Chart 4.2.1

maps one of the treatment paths for

stage III and IV cancers. Treatment begins with 2

cycles of ABVD. If treatment results look good, 4

more ABVD cycles are advised. Radiation therapy

may follow.

If ABVD results appear less than wanted, there are

two options. The first option is 4 more ABVD cycles

followed by testing. Follow-up care or radiation

therapy can be received if ABVD results are good.

If results are less than wanted, radiation therapy is

advised. If results look poor but no cancer is found

by biopsy, you may start follow-up care or receive

radiation therapy. If cancer is found, read Part 4.3 to

learn which treatments you can receive next.

The second option after 2 ABVD cycles is 4

BEACOPP cycles. This is an intense treatment that

is likely to be hard on your body. Read Chart 4.2.3 to

learn your treatment options after BEACOPP.

Chart 4.2.2

maps a second treatment path for stage

III and IV cancers. Treatment starts with 12 weeks of

Stanford V. 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.

Chart 4.2.3

maps a third treatment pathway for

some stage III or IV cancers. This path includes

intense treatment that is likely to be hard on your

body. Thus, you should be younger than 60 years old.

Also, your IPS (

I

nternational

P

rognostic

S

core) should

be 4 or greater. IPS is based on seven factors, such

as blood test results. If unknown, ask your doctor

what your IPS is.

Treatment starts with 6 cycles of BEACOPP. If

treatment results look good, you can start follow-

up care. If ABVD results appear less than wanted,

radiation therapy is advised. If results look poor but no

cancer is found by biopsy, you may 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 4.2.3 Option 3 if younger than 60 years, ≥ 4 IPS

Treatment

Test results

Treatment

Radiation therapy

Start follow-up care

More cancer drugs

Treatment may be working poorly;

No cancer is found with biopsy

Treatment may be working poorly;

Cancer is found with biopsy

Treatment appears to be working well

Treatment appears to be working

less than wanted

6 cycles of BEACOPP

Start follow-up care

Radiation therapy

4

Treatment guide: Classical Hodgkin lymphoma Stages III and IV treatment