Hodgkin's lymphoma.

INTRODUCTION

People with Hodgkin's lymphoma usually present with a lump in the neck or upper chest, but a quarter of people also have fever, sweating, weight loss, fatigue, and itch. Almost all people with localised disease can be cured, and, even among people with relapsed advanced disease, almost 80% of them survive event-free for 4 years or longer.

METHODS AND OUTCOMES

We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of: single-regimen chemotherapy treatments; combined chemotherapy and radiotherapy treatments compared with radiotherapy alone; and combined chemotherapy and radiotherapy treatments compared with the same chemotherapy agent alone, for first presentation stage 1 or 2 non-bulky disease? What are the effects of: specific combined chemotherapy and radiotherapy treatments versus each other; or different radiotherapy treatment strategies in stage 1 or 2 non-bulky disease? What are the effects of: single-regimen chemotherapy treatments; dose intensified chemotherapy treatments; or combined chemotherapy plus radiotherapy treatments compared with chemotherapy alone, for first presentation stage 2 bulky disease, stage 3, or stage 4 disease? We searched: Medline, Embase, The Cochrane Library and other important databases up to May 2005 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS

We found 45 systematic reviews, RCTs, or observational studies that met our inclusion criteria.

CONCLUSIONS

In this systematic review we present information relating to the effectiveness and safety of the following interventions: ABVD (with or without radiotherapy), ABVPP plus radiotherapy, ChlVPP-EVA, combined regimens with radiotherapy, COPP-ABVD plus radiotherapy, CVPP plus radiotherapy, EBPV plus radiotherapy, escalating dose BEACOPP, extended field radiotherapy, increased-dose regimens, involved field radiotherapy, MOPP (with or without radiotherapy), MOPP-ABV plus radiotherapy, VAPEC-B, and VBM plus radiotherapy.