Details

Autor(en) / Beteiligte

• NOORDIJK, Evert M
• CARDE, Patrice
• ALEMAN, Berthe M. P
• BOSQ, Jacques
• VOVK, Marjeta
• VERSCHUEREN, Tom A. M
• PENY, Anne-Marie
• GIRINSKY, Théodore
• RAEMAEKERS, John M. M
• HENRY-AMAR, Michel
• DUPOUY, Noëlle
• HAGENBEEK, Anton
• KROL, Augustinus D. G
• KLUIN-NELEMANS, Johanna C
• TIRELLI, Umberto
• MONCONDUIT, Mathieu
• THOMAS, José
• EGHBALI, Houchingue

Titel

Combined-Modality Therapy for Clinical Stage I or II Hodgkin's Lymphoma: Long-Term Results of the European Organisation for Research and Treatment of Cancer H7 Randomized Controlled Trials

Ist Teil von

• Journal of clinical oncology, 2006-07, Vol.24 (19), p.3128-3135

Ort / Verlag

Baltimore, MD: American Society of Clinical Oncology

Erscheinungsjahr

2006

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• In early-stage Hodgkin's lymphoma (HL), subtotal nodal irradiation (STNI) and combined chemotherapy/radiotherapy produce high disease control rates but also considerable late toxicity. The aim of this study was to reduce this toxicity using a combination of low-intensity chemotherapy and involved-field radiotherapy (IF-RT) without jeopardizing disease control. Patients with stage I or II HL were stratified into two groups, favorable and unfavorable, based on the following four prognostic factors: age, symptoms, number of involved areas, and mediastinal-thoracic ratio. The experimental therapy consisted of six cycles of epirubicin, bleomycin, vinblastine, and prednisone (EBVP) followed by IF-RT. It was randomly compared, in favorable patients, to STNI and, in unfavorable patients, to six cycles of mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPP/ABV hybrid) and IF-RT. Median follow-up time of the 722 patients included was 9 years. In 333 favorable patients, the 10-year event-free survival rates (EFS) were 88% in the EBVP arm and 78% in the STNI arm (P = .0113), with similar 10-year overall survival (OS) rates (92% v 92%, respectively; P = .79). In 389 unfavorable patients, the 10-year EFS rate was 88% in the MOPP/ABV arm compared with 68% in the EBVP arm (P < .001), leading to 10-year OS rates of 87% and 79%, respectively (P = .0175). A treatment strategy for early-stage HL based on prognostic factors leads to high OS rates in both favorable and unfavorable patients. In favorable patients, the combination of EBVP and IF-RT can replace STNI as standard treatment. In unfavorable patients, EBVP is significantly less efficient than MOPP/ABV.