Jeff Ryckman: Omitting RT in bulky early-stage cHL

Jeff Ryckman, Radiation Oncologist and Assistant Professor at West Virginia University, shared the following post on LinkedIn:

“CALGB50801: Omitting RT in bulky (>10 cm or 1/3 the maximum intrathoracic diameter) early-stage cHL

• Omits RT at expense of 2 addnl cycles of ABVD.
• Does not discuss the degree of CT-based residual.
• Utilized outdated RT methods (IFRT) in SER.
• Each cycle of ABVD is equivalent to 5 Gy mean heart dose (MHD) – EORTC-LYSA: View it here.
• CALGB50801 “delivers” 10 Gy MHD by omitting RT and replacing it with adria x2c:
• CCSS St. Jude CV Risk calculator

Why does RT-free survival continue to be a thing with modern RT techniques?
Protons most useful if below L main coronary A or mediastinum+axilla in young female

TL;DR Addn’l Adriamycin is not benign! Modern RT techniques have come a long way.”

For the article click here.
Source: Jeff Ryckman/Twitter