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The Bigger Picture: ABVD-based Treatment Does
not Cure Enough High Risk HL.
• 5 year survival in US for patients with
advanced stage HL is comparable to node
+’ve colorectal cancer and worse than
node +’ve breast cancer.
• The 5-year risk of relapse is likely >2-3
fold higher than the 30-year risk of second
cancer even if RT is given.
• Relapsed HL is by far the most common
second cancer likely to be experienced by
a patient with high-risk HL treated with
ABVD.
• Conflating “readily curable” early
favourable HL with the outcome of high
risk HL risks under-treating the latter.
J Clin Oncol 31: 684-691; 2012
ECOG E2496
RT given to 41% of ABVD
patients and 75% of S5 patients