NCCN QUICK GUIDE
Hodgkin Lymphoma, Version 1.2015
Classical HL TreatmentNCCN.org - For Clinicians
|NCCN.org/patients - For Patients
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What are options for first-time treatment?
Stage III and IV cancers are on both sides of your diaphragm or have
widely spread outside the lymphatic system.36
One option is 2 ABVD cycles then either 4 ABVD or BEACOPP
cycles, which are often followed by radiation therapy. A second option
is 12 weeks of Stanford V followed by radiation therapy. If younger
than 60 years with a good cancer outlook, a third option is 6 cycles of
BEACOPP, which may be followed by radiation therapy.44
What if first-time treatment doesn’t work?
Cancer that grows during or soon after first-time treatment is called refractory disease.
Chemotherapy or brentuximab vedotin is first used to shrink the cancer. If treatment is or
may be working, you may have a stem cell transplant with or without radiation therapy. If
treatment doesn’t work, you may receive other drug treatments with or without radiation
therapy. Radiation therapy alone is also an option to treat refractory disease following
chemotherapy or brentuximab vedotin.46
What are options if the cancer returns?
Cancer that re-appears on tests after a cancer-free period is called a relapse. Treatment
options for stage IA or IIA depend on whether you had radiation therapy before. If not,
chemotherapy or brentuximab vedotin with or without stem cell transplant, radiation therapy,
or both is first used to treat relapse. For some people, radiation therapy alone may be first
used. Treatment for all other relapsed cancers is like treatment for refractory disease.48
What care should I receive after treatment?
Follow-up care starts when there are no signs of cancer after treatment. It should consist
of health tests that check for cancer and any problems caused by cancer treatment. It’s
also important to get care that will help to prevent other illnesses.50
How do I decide between options?
Ask your doctors many questions. Also, you could get a second opinion, attend support
groups, and compare pros and cons.72 Ü