A limited role for VEEP (vincristine, etoposide, epirubicin, prednisolone) chemotherapy in childhood Hodgkin's disease
| Autor: | J.E Kingston, A Atra, Sue Ashley, CR Pinkerton, M Mott, Ananth Shankar |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Vincristine Adolescent medicine.medical_treatment Prednisolone Disease-Free Survival Cohort Studies Recurrence Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Progression-free survival Child Etoposide Epirubicin Salvage Therapy Chemotherapy business.industry Hodgkin Disease Surgery Regimen B symptoms Child Preschool Disease Progression Female medicine.symptom business medicine.drug Follow-Up Studies |
| Zdroj: | European journal of cancer (Oxford, England : 1990). 34(13) |
| ISSN: | 0959-8049 |
| Popis: | The VEEP regimen (vincristine, etoposide, epirubicin, prednisolone), with or without involved field radiotherapy, has been shown to be an effective treatment in adult Hodgkin's disease. In an attempt to avoid the late sequelae of both alkylating agents and radiotherapy this regimen has been studied in a series of 54 children and young adults. Early analysis suggested that the relapse rate was higher with VEEP than with standard alkylating agent-based regimens. Sufficient follow-up has now been achieved to evaluate the likelihood of sustained remission following second-line treatment and therefore the overall long term survival with this treatment approach. The 5-year Overall Survival (OS) and 5-year Progression Free Survival (PFS) for patients with stage I–III disease was 93% and 82% respectively. However, the 5-year OS and PFS for stage IV patients was only 44% and 50%, respectively. Of 13 patients who were initial treatment failures on VEEP, 7 of whom had advanced disease, only 6 were salvaged with second-line therapy. 8 of 33 who attained a complete response (CR) relapsed and there were 2 relapses in those achieving a partial response (PR) ( n =8). All those relapsing from CR/PR were salvaged by second-line alkylating agent chemotherapy±radiotherapy, ±high dose chemotherapy. In conclusion, patients with stage I–IIIA, non-bulky disease, the moderately high relapse rate did not adversely affect the overall high cure rate, although VEEP failures were subjected to a high total treatment burden. VEEP alone is inadequate in patients with stage IV disease, bulky mediastinal disease in/or those with B symptoms in whom there is a high primary failure rate and relatively poor results with second line therapy. |
| Databáze: | OpenAIRE |
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