{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:10:40Z","timestamp":1791526240293,"version":"4.3.4"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"31","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Combined-modality treatment (CMT) with 2\u00d7 ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and small-field radiotherapy is standard of care for patients with early-stage favorable Hodgkin lymphoma (HL). However, the role of radiotherapy has been challenged. Positron emission tomography (PET) after 2\u00d7 ABVD (PET-2) might help to predict individual outcomes and guide treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Between November 2009 and December 2015, we recruited patients age 18 to 75 years with newly diagnosed, early-stage favorable HL for this international randomized phase III trial. Patients were assigned to standard CMT of 2\u00d7 ABVD and 20-Gy involved-field radiotherapy or PET-guided treatment, omitting involved-field radiotherapy after negative PET-2 (Deauville score &lt; 3). Primary objectives were to exclude inferiority of 10% or more in 5-year progression-free survival (PFS) of ABVD alone compared with CMT in a per-protocol analysis among PET-2\u2013negative patients (noninferiority margin for hazard ratio, 3.01) and to confirm PET-2 positivity (Deauville score \u2265 3) as a risk factor for PFS among CMT-treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We enrolled 1,150 patients. Median follow-up was 45 months. Among 628 PET-2\u2013negative, per-protocol\u2013treated patients, 5-year PFS was 93.4% (95% CI, 90.4% to 96.5%) with CMT and 86.1% (95% CI, 81.4% to 90.9%) with ABVD (difference 7.3% [95% CI, 1.6% to 13.0%]; hazard ratio, 1.78 [95% CI, 1.02 to 3.12]). Five-year overall survival was 98.1% (95% CI, 96.5% to 99.8%) with CMT and 98.4% (95% CI, 96.5% to 100.0%) with ABVD. Among 693 patients who were assigned to CMT, 5-year PFS was 93.2% (95% CI, 90.2% to 96.2%) among PET-2\u2013negative patients and 88.4% (95% CI, 84.2% to 92.6%) in PET-2\u2013positive patients ( P = .047). When using the more common liver cutoff (Deauville score, 4) for PET-2 positivity, the difference was more pronounced (5-year PFS, 93.1% [95% CI, 90.7% to 95.5%] v 80.9% [95% CI, 72.2% to 89.7%]; P = .0011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In early-stage favorable HL, a positive PET after two cycles ABVD indicates a high risk for treatment failure, particularly when a Deauville score of 4 is used as a cutoff for positivity. In PET-2\u2013negative patients, radiotherapy cannot be omitted from CMT without clinically relevant loss of tumor control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.19.00964","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T15:59:29Z","timestamp":1568044769000},"page":"2835-2845","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":225,"title":["Positron Emission Tomography\u2013Guided Treatment in Early-Stage Favorable Hodgkin Lymphoma: Final Results of the International, Randomized Phase III HD16 Trial by the German Hodgkin Study Group"],"prefix":"10.1200","volume":"37","author":[{"given":"Michael","family":"Fuchs","sequence":"first","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Goergen","sequence":"additional","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Kobe","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Kuhnert","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Lohri","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Baselland, Liestal, Switzerland"},{"name":"Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Greil","sequence":"additional","affiliation":[{"name":"IIIrd Medical Department, Paracelcus Medical University and Salzburg Cancer Research Institute, Salzburg, Austria"},{"name":"Salzburg Cancer Research Institute and AGMT (Arbeitsgemeinschaft Medikament\u00f6se Tumortherapie), Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Sasse","sequence":"additional","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max S.","family":"Topp","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Universit\u00e4tsklinikum W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erhardt","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Dres. med. Just\/D\u00fcwel\/Riesenberg\/Steinke\/Sch\u00e4fer, Studiengesellschaft, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Hertenstein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Klinikum Bremen Mitte, Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Soekler","sequence":"additional","affiliation":[{"name":"University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Vogelhuber","sequence":"additional","affiliation":[{"name":"Medizinische Klinik III, Universit\u00e4tsklinik Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9e M.","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Center, Vrije Universiteit, Department of Hematology, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich Bernd","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Klinikum \u201cRechts der Isar\u201d, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan W.","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 5, Haematology\/Oncology, University of Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Klinikum N\u00fcrnberg, Paracelsus Medical University, N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Maschmeyer","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Thiemer","sequence":"additional","affiliation":[{"name":"Clinic for Hematology, Oncology and Immunology, Philipps University, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"D\u00fchrsen","sequence":"additional","affiliation":[{"name":"Department of Haematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Meissner","sequence":"additional","affiliation":[{"name":"University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Viardot","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Eich","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, University Hospital of Muenster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Baues","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Diehl","sequence":"additional","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Rosenwald","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Julius Maximilian University of W\u00fcrzburg and Comprehensive Cancer Center Mainfranken, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"von Tresckow","sequence":"additional","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Dietlein","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Borchmann","sequence":"additional","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Engert","sequence":"additional","affiliation":[{"name":"German Hodgkin Study Group (GHSG), Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.4396"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2006.05.015"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2009.015644"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505949"},{"key":"B5","first-page":"CD008814","volume":"9","author":"Franklin J","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-06-291328"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djk029"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp147"},{"key":"B9","first-page":"475","volume":"91","author":"Gallamini A","year":"2006","journal-title":"Haematologica"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23994"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000067"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1080\/10428190903040048"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000149"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-12505-3"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197507)36:1<252::AID-CNCR2820360128>3.0.CO;2-7"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa064601"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.07.0482"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408648"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.6394"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.06.039"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.5911"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2018.1540781"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.39"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.9174"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12327"},{"key":"B26","first-page":"3","volume":"111","author":"Schellong G","year":"2014","journal-title":"Dtsch Arztebl Int"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.19.00964","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T06:28:11Z","timestamp":1653805691000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.19.00964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,1]]},"references-count":26,"journal-issue":{"issue":"31","published-print":{"date-parts":[[2019,11,1]]}},"alternative-id":["10.1200\/JCO.19.00964"],"URL":"https:\/\/doi.org\/10.1200\/jco.19.00964","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,1]]},"assertion":[{"value":"2019-08-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}