TABLE 5.

A 25-Year-Old Woman With Stage IIA Nodular Sclerosing Hodgkin Lymphoma With Bilateral Supraclavicular and Mediastinal (7 cm in Widest Diameter) Involvement; Normal ESR. Interim PET/CT Scan Demonstrates Deauville 3 in Mediastinum

Treatment	Rating	Comments
Chemotherapy and ISRT	9
Chemotherapy and IFRT	6
Chemotherapy alone	6
Duration of ABVD (if chemotherapy given alone)
2 cycles	2
4 cycles	5
6 cycles	7	This option assumes interim PET was negative after 4 cycles of chemotherapy
Duration of ABVD (combined modality)
2 cycles	5	This option may be appropriate but there was disagreement among panel members on the appropriateness rating as defined by the panel’s median rating
4 cycles	6
6 cycles	4
Dose of radiation therapy (combined modality)
20 Gy	5	This option may be appropriate but there was disagreement among panel members on the appropriateness rating as defined by the panel’s median rating
30 Gy	7
30 Gy + 6 Gy boost to mediastinum	5

Rating scale: 1, 2, 3 usually not appropriate; 4, 5, 6 may be appropriate; 7, 8, 9 usually appropriate.

ABVD indicates doxorubicin, bleomycin, vinblastine, and dacarbazine; ESR, erythrocyte sedimentation rate; IFRT, involved field radiation therapy; ISRT, involved site radiation therapy; PET/CT, positron emission tomography/computed tomography.