Abstract |
The treatment of advanced Hodgkin's disease (HD) with chemotherapy (CTx) alone or combined modality treatments has been controversial. In 1989, we designed a randomized study to compare 2 cycles of CTx to (sub)total nodal irradiation (RTx) as consolidation treatments for patients with stage IIIB/IV HD in complete remission (CR) or good partial response after 6 cycles of CTx. A total of 559 patients were randomized to receive 6 cycles of MOPP/ABV ( mechlorethamine, vincristine, procarbazine, prednisone/ Adriamycin [ doxorubicin], bleomycin, vinblastine) hybrid (n = 266) or ABVPP (n = 267). After induction treatment, 418 patients could be evaluated for the consolidation phase. With a median follow-up of 48 months, the 5-year disease-free survival estimates were 80% for 8 cycles of MOPP/ABV, 82% for 6 cycles of MOPP/ABV plus RTx, 68% for 8 cycles of ABVPP, and 75% for 6 cycles of ABVPP plus RTx (P =.01). The 5-year disease-free survival estimates did not differ between CTx and RTx, 74% and 79%, respectively (P =.07). After MOPP/ABV, the 5-year overall survival estimates did not differ between CTx and RTx, 85% and 88%, respectively ( P =.2). After ABVPP, the 5-year survival estimates were 94% for CTx and 78% for RTx (P =.002). These results showed that RTx was not superior to CTx consolidation after doxorubicin-induced CR for patients with advanced HD. Because of the uncertainty of obtaining a prolonged second remission for patients relapsing after CTx and RTx and the possible long-term effects of RTx, we prefer 8 cycles of CTx as standard treatment when a CR has been achieved after 6 cycles.
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Authors | C Fermé, C Sebban, C Hennequin, M Diviné, P Lederlin, J Gabarre, A Ferrant, D Caillot, D Bordessoule, P Brice, I Moullet, F Berger, E Lepage |
Journal | Blood
(Blood)
Vol. 95
Issue 7
Pg. 2246-52
(Apr 01 2000)
ISSN: 0006-4971 [Print] United States |
PMID | 10733492
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Bleomycin
- Procarbazine
- Mechlorethamine
- Vincristine
- Vinblastine
- Doxorubicin
- Prednisone
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Topics |
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage)
- Bleomycin
(administration & dosage)
- Combined Modality Therapy
- Disease-Free Survival
- Doxorubicin
(administration & dosage)
- Hodgkin Disease
(drug therapy, mortality, radiotherapy)
- Humans
- Mechlorethamine
(administration & dosage)
- Middle Aged
- Neoplasm Staging
- Prednisone
(administration & dosage)
- Procarbazine
(administration & dosage)
- Prospective Studies
- Remission Induction
- Survival Rate
- Vinblastine
(administration & dosage)
- Vincristine
(administration & dosage)
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