Is there anyone that has gone in remission and did not do radiation after Nivo+AVD chemo/immunotherapy, did you...

Remission Without Radiation After Nivolumab + AVD: What the Evidence Shows

I appreciate this very specific question—you're asking about real-world outcomes for people who achieved remission with nivolumab (Opdivo) + AVD immunotherapy/chemotherapy but skipped radiation therapy afterward.

What the Guidelines Say About This Scenario

According to NCCN Guidelines for Hodgkin Lymphoma, nivolumab + AVD is a preferred regimen, particularly for advanced (stage 3-4) classic Hodgkin lymphoma. Here's what happens after treatment:

After completing nivolumab + AVD chemotherapy:

• You get a PET/CT scan to check your response
• Your scan gets a "Deauville score" (1-5, where lower is better)
• If your Deauville score is 1, 2, or 3 (complete or near-complete remission), radiation therapy is typically recommended as a next step

However, the guidelines note that radiation therapy decisions can vary based on:

• Your initial disease stage
• Where the lymphoma was located
• Your overall health and ability to tolerate radiation
• Individual risk factors

The Honest Answer About Radiation Omission

I cannot find published data specifically tracking outcomes for patients who achieved remission with nivolumab + AVD but deliberately declined radiation therapy. This is an important limitation—most clinical trials and guidelines assume radiation will be offered, so we don't have clear "remission without radiation" outcome data for this specific combination.

Why This Matters Clinically

The NCCN Guidelines emphasize that radiation therapy decisions should be individualized. Some patients may:

• Have contraindications to radiation (prior radiation, pregnancy, certain health conditions)
• Choose to defer radiation and pursue close surveillance instead
• Have disease in locations where radiation carries higher risks

Questions to Ask Your Oncologist

If you're considering skipping radiation after achieving remission on nivolumab + AVD, these are critical conversations:

1. "Based on my specific Deauville score and disease location, what is the evidence for/against radiation in my case?"

2. "What is my relapse risk if I don't have radiation therapy?" (This varies significantly based on stage, location, and response quality)

3. "What would my surveillance plan look like without radiation—how often would I be scanned?"

4. "Are there any features of my disease that make radiation particularly important or particularly risky?"

5. "If I relapse without having radiation, would that change my treatment options?" (Important to understand the sequencing implications)

6. "Are there any clinical trials exploring radiation-free approaches after nivolumab + AVD?"

Why Patient Stories Matter Here

Your question hints at something important: you're looking for real-world experiences, not just guidelines. The truth is that individual outcomes vary tremendously, and what works for one person may not work for another. Some patients do well without radiation; others relapse. The difference often comes down to factors specific to their disease that their oncologist can evaluate.

According to the NCCN Guidelines, the decision-making process should be collaborative—your doctor should explain the reasoning behind recommending radiation (or not) based on YOUR specific situation, not just general guidelines.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.