Is there convincing evidence for the use of chemotherapy alone in patients with limited stage Hodgkin's lymphoma?
Bibliographic record
Abstract
Standard practices for patients with stages I and IIA non-bulky Hodgkin's lymphoma have evolved to include combined-modality therapy consisting of two or three cycles of ABVD and radiation therapy to the involved field. Long-term disease control can be expected in more than 90% of patients. However, long-term survival will also be dependent on the occurrence of treatment-related toxicities (late-effects) that include second cancers and cardiovascular events; deaths from these causes will outnumber those due to progressive Hodgkin's lymphoma. Data from randomized trials testing the role of chemotherapy alone are now available. These trials are based on the hypothesis that avoidance of radiation therapy will result in fewer deaths from late-effects, and that long-term survival will be at least comparable and possibly superior. With intermediate periods of follow-up, the results of these randomized trials demonstrate that with chemotherapy alone, disease control is reduced by approximately 5-7%, but this difference has not translated into a survival advantage. While further follow-up is required to evaluate longer term overall survival, current data can be interpreted as showing that a trade-off exists that requires balancing the advantage of superior disease control achieved with inclusion of radiation therapy and minimization of late-effects resulting from use of chemotherapy alone. The balance associated with this trade-off makes chemotherapy alone a legitimate treatment option; patients and clinicians need to be aware of these options in when making treatment decisions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".