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Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma

Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma

Authors :
Vassilakopoulos, Theodoros P.
Angelopoulou, Maria K.
Siakantaris, Marina P.
Kontopidou, Flora N.
Dimopoulou, Maria N.
Kokoris, Styliani I.
Kyrtsonis, Marie Christine
Tsaftaridis, Panayiotis
Karkantaris, Christos
Anargyrou, Konstantinos
Boutsis, Dimitrios E.
Variamis, Eleni
Michalopoulos, Thymios
Boussiotis, Vassiliki A.
Panayiotidis, Panayiotis
Papavassiliou, Constantinos
Pangalis, Gerassimos A.
Source :
International Journal of Radiation Oncology, Biology, Physics. Jul2004, Vol. 59 Issue 3, p765-781. 17p.
Publication Year :
2004

Abstract

Purpose: To present our long-term experience regarding the use of chemotherapy plus low-dose involved-field radiotherapy (IFRT) for clinical Stage I-IIA Hodgkin''s lymphoma.Methods and materials: We analyzed the data of 368 patients. Of these, 66 received mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and 302 received doxorubicin (or epirubicin), bleomycin, vinblastine, and dacarbazine [A(E)BVD]. Patients with complete remission or very good partial remission were scheduled for low-dose IFRT (≤3200 cGy).Results: The 10-year failure-free survival (FFS) and overall survival (OS) rate was 85% and 86%, respectively. A(E)BVD-treated patients had superior 10-year FFS and OS rates compared with MOPP-treated patients (87% vs. 75%, p = 0.009; and 93% vs. 71%, p = 0.0004, respectively). Only 10 of 41 relapses had any infield (irradiated) component. Of the complete responders/very good partial responders treated with low-dose IFRT, those who received <2800 cGy had inferior FFS but similar OS as those who received 2800–3200 cGy. Adverse prognostic factors for FFS included age ≥45 years, leukocytosis ≥10 × 109/L, and extranodal extension. Secondary acute leukemia developed after MOPP with or without salvage therapy (n = 6) or after ABVD plus salvage therapy (n = 2). None of the nine secondary solid tumors developed within the RT fields.Conclusion: IFRT at a dose of 2800–3000 cGy is highly effective in clinical Stage I-IIA HL patients who achieved a complete response or very good partial response with A(E)BVD. The long-term toxicity with respect to secondary malignancies appears to be acceptable. [Copyright &y& Elsevier]

Details

Language :
English
ISSN :
03603016
Volume :
59
Issue :
3
Database :
Academic Search Index
Journal :
International Journal of Radiation Oncology, Biology, Physics
Publication Type :
Academic Journal
Accession number :
13292132
Full Text :
https://doi.org/10.1016/j.ijrobp.2003.11.029