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- dality treatment and proven to be safe. We argue below that Longo overestimated the efficacy of chemotherapy alone in the treat - ment of Hodgkin lymphoma while at the same time underestimating the toxicity of this treatment. The possible value of radia - tion for patients with Hodgkin lymphoma was not recognized, whereas its toxicity was overrated. Moreover, Longo's criticism against the use of radiotherapy was based on outdated concepts regarding radiation It is essential to realize that our article involved patients treated in the past with radiation volumes, doses, and techniques that are no longer used. However, the results of our investigation are important to devise risk-reducing strategies for survivors at high risk of late radiation-induced effects and to adapt treatment strategies for future patients that reduce the risks of late effects as much as possible. In conclusion, changes in therapy should be made only in the context of carefully designed clinical trials that evaluate whether the overall efficacy of treatment is main - tained. Treatment of patients with Hodgkin lymphoma should consist of chemotherapy followed by radiation if indicated by patient and tumor characteristics and the patient's response to chemotherapy as evaluated using modern techniques, such as fluorine- 18-fluorodeoxyglucose positron emission tomography scans. When radiotherapy is applied, volume and dose should be as limited as possible and modern imaging and radiation techniques should be used.

Re: Late Effects From Radiation Therapy: The Hits Just Keep on Coming