Back to Search
Start Over
Extended-field radiotherapy is superior to MOPP chemotherapy for the treatment of pathologic stage I-IIA Hodgkin's disease: eight-year update of an Italian prospective randomized study.
Extended-field radiotherapy is superior to MOPP chemotherapy for the treatment of pathologic stage I-IIA Hodgkin's disease: eight-year update of an Italian prospective randomized study.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 1992 Mar; Vol. 10 (3), pp. 378-82. - Publication Year :
- 1992
-
Abstract
- Purpose: To compare the effectiveness of chemotherapy (CHT) with extended-field radiotherapy (RT) in the treatment of early-stage Hodgkin's disease (ESHD), we report an 8-year updated analysis of a study in which treatment with six cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) CHT was randomly compared with extended-field RT.<br />Patients and Methods: From August 1979 to December 1982, 89 adult patients with pathologic stage I-IIA Hodgkin's disease (HD) were randomly allocated to receive either RT with mantle field followed by periaortic irradiation (n = 45) or six monthly courses of MOPP CHT (n = 44).<br />Results: All patients in the RT arm and 40 of 44 in the CHT arm achieved complete remission. Twelve relapses occurred in each group. Eight patients treated with MOPP and two of the RT arm died of HD. Three other patients of the CHT group died because of a second cancer. With a median follow-up greater than 8 years, the overall survival rate is significantly higher in the RT than in the CHT group (93% v 56%; P less than .001), whereas the rates of freedom from progression and relapse-free survival (RFS) were similar in the two groups (76% v 64% and 70% v 71%, respectively). Of the 12 patients relapsing after RT, 11 (92%) achieved a second CR, compared with only six of the 12 (50%) in the MOPP group. Analysis of the response rate to salvage treatments showed that the type of relapse in the MOPP group was a prognostic indicator for the achievement of a second CR, whereas in the RT group, a second CR was obtained regardless of the characteristics of the relapses. At 80 months, the probability of survival of relapsing patients calculated from time of relapse was 85% and 15% in the RT and CHT groups, respectively (P = .02).<br />Conclusion: We conclude that RT alone is the treatment of choice for adult patients with ESHD with favorable prognostic factors.
- Subjects :
- Actuarial Analysis
Female
Hodgkin Disease pathology
Humans
Male
Mechlorethamine administration & dosage
Multivariate Analysis
Neoplasm Staging
Prednisone administration & dosage
Procarbazine administration & dosage
Prospective Studies
Radiotherapy methods
Recurrence
Survival Analysis
Vincristine administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Hodgkin Disease drug therapy
Hodgkin Disease radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 10
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 1740677
- Full Text :
- https://doi.org/10.1200/JCO.1992.10.3.378