Shifting the Balance of Therapeutic Radiation in Adolescent and Young Adult Hodgkin Lymphoma.

Over recent decades, the use of radiotherapy (RT) in classic Hodgkin lymphoma has shifted toward more conservative, individualized application. In this issue of Cancer Epidemiology, Biomarkers & Prevention, Corrigan and colleagues report on real-world RT utilization trends in adolescent and young adult (AYA) patients in the National Cancer Database who were treated for classic Hodgkin lymphoma from 2004 to 2020 in the United States. The findings parallel broader trends seen in pediatric and adult classic Hodgkin lymphoma toward a lower proportion of patients receiving RT and a reduction in the anatomic regions targeted with RT. Additionally, Corrigan and colleagues identified several demographic factors that were associated with RT receipt, at least some of which may reflect systemic disparities in healthcare delivery. As management strategies in AYA classic Hodgkin lymphoma continue to evolve, ongoing study using large databases will be critical to assess the adoption of evidence-based, equitable practices that maximize disease control and minimize deleterious late effects. The AYA population warrants special attention given their unique characteristics that may affect treatment strategies and patterns of care. See related article by Corrigan et al., p. 1483.