Document Detail


Augmented therapy of extensive Hodgkin's disease: radiation to known disease or prolongation of induction chemotherapy did not improve survival--results of a Cancer and Leukemia Group B study.
MedLine Citation:
PMID:  9635714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This prospective randomized trial in extensive untreated Hodgkin's disease was undertaken to assess the potential benefit of augmented therapy (12 months chemotherapy or radiation to known disease) compared to standard 6 months chemotherapy. PATIENT AND METHODS: A total of 258 patients, mostly Stage IV, were randomized to four treatment regimens consisting of six cycles of CCNU, vinblastine, procarbazine, and prednisone (CVPP); 12 cycles of CVPP; six cycles of CVPP followed by 25 Gy radiotherapy; or three cycles CVPP, 25 Gy radiotherapy, and three cycles CVPP. RESULTS: Complete remissions were achieved in 65% of all patients. A 58% overall 5-year survival rate was obtained. Relapses in irradiated areas of known disease occurred in only 6% of responding patients. There was, however, no statistical difference in response frequency, disease-free survival, or overall survival among the four regimens. Elderly patients responded less frequently. CONCLUSION: While radiotherapy provided control of local (known) disease, no impact on overall survival was apparent. Likewise, doubling the duration of chemotherapy did not improve response or survival. Augmentation of therapy with either radiotherapy or more chemotherapy in this study was of no benefit compared to the standard 6 months of treatment.
Authors:
M Coleman; S Rafla; K J Propert; A Glicksman; B Peterson; N Nissen; K Brunner; J F Holland; J R Anderson; A Gottlieb; T Kaufman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  41     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-06-30     Completed Date:  1998-06-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  639-45     Citation Subset:  IM    
Affiliation:
New York Hospital-Cornell Medical Center, NY 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Combined Modality Therapy
Disease-Free Survival
Female
Hodgkin Disease / drug therapy*,  radiotherapy*
Humans
Lomustine / administration & dosage
Male
Middle Aged
Prednisone / administration & dosage
Procarbazine / administration & dosage
Prospective Studies
Vinblastine / administration & dosage
Grant Support
ID/Acronym/Agency:
CA-02599/CA/NCI NIH HHS; CA-07968/CA/NCI NIH HHS; CA-12011/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/CVPP protocol; 13010-47-4/Lomustine; 53-03-2/Prednisone; 671-16-9/Procarbazine; 865-21-4/Vinblastine

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