ABVD Plus Subtotal Nodal Versus Involved-Field Radiotherapy in Early-Stage Hodgkin's Disease: Long-Term Results
| Autor: | Anna Di Russo, Pinuccia Valagussa, Simonetta Viviani, Valeria Bonfante, F. Villani, Gianni Bonadonna |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Time Factors Adolescent Dacarbazine medicine.medical_treatment Vinblastine Bleomycin chemistry.chemical_compound Antineoplastic Combined Chemotherapy Protocols Humans Medicine Prospective Studies Stage (cooking) Neoplasm Staging Radiotherapy business.industry Remission Induction Middle Aged medicine.disease Combined Modality Therapy Hodgkin Disease Lymphoma Surgery Radiation therapy Treatment Outcome Oncology chemistry Tolerability ABVD Doxorubicin Disease Progression Female Radiology business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 22:2835-2841 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2004.12.170 |
| Popis: | Purpose Radiation therapy (RT) alone can cure more than 80% of all patients with pathologic stage IA, IB, and IIA Hodgkin's disease, but some prognostic factors unfavorably affect treatment outcome. Combined-modality approaches improved results compared with RT, but the optimal extent of RT fields when combined with chemotherapy warranted additional evaluation. Patients and Methods In February 1990, we activated a prospective trial in patients with early, clinically staged Hodgkin's disease to assess efficacy and tolerability of four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by either subtotal nodal plus spleen irradiation (STNI) or involved-field radiotherapy (IFRT). Results Main patient characteristics were fairly well balanced between the two arms. Complete remission was achieved in 100% and in 97% of patients, respectively. The 12-year freedom from progression rates were 93% (95% CI, 83% to 100%) after ABVD and STNI, and 94% (95% CI, 88% to 100%) after ABVD and IFRT, whereas the figures for overall survival were 96% (95% CI, 91% to 100%) and 94% (95% CI, 89% to 100%), respectively. Apart from three patients who developed second malignancies in the STNI arm, treatment-related morbidities were mild. Conclusion Present long-term findings suggest that, after four cycles of ABVD, IFRT can achieve a worthwhile outcome. The limited size of our patient sample, however, had no adequate statistical power to test for noninferiority of IFRT versus STNI. Despite this, ABVD followed by IFRT can be considered an effective and safe modality in early Hodgkin's disease with both favorable and unfavorable presentation. |
| Databáze: | OpenAIRE |
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