|Bulky mediastinal Hodgkin's disease: results of a combined modality approach (ABVD/MOPP alternating chemotherapy plus radiation therapy).|
|PMID: 7507457 Owner: NLM Status: MEDLINE|
|BACKGROUND: Bulky mediastinal involvement is a challenging presentation of Hodgkin's disease (HD). Radiotherapy alone has provided a good response rate but also a high percentage of recurrences, and therefore many studies have been initiated to evaluate combined modality treatment. METHOD: In a prospective study 23 stage IIA/IIIB HD patients treated with ABVD/MOPP alternating chemotherapy and radiotherapy were evaluated with regard to overall (OS) and disease-free survival (DFS), acute and long-term toxicity. RESULTS: A 95% CR rate was obtained. Ten-year actuarial OS and DFS were 83 and 91%, respectively. Two patients (8.8%) relapsed 8 and 9 months after achieving CR. One patient (4.4%) died following severe bone marrow failure 25 months after diagnosis. No clinically evident acute or chronic cardiac or pulmonary toxicity was evident, and no second malignancies were observed. At the end of therapy 7/14 evaluable women became amenorrheal and remained so at their last follow-up. Two male patients were considered azoospermic on the basis of laboratory evaluation at the end of therapy, and after 68 and 122 months, respectively; 4 of 5 male patients had sexual intercourse freely but did not fertilize their partners. CONCLUSIONS: In our opinion and in agreement with available literature, chemotherapy has a fundamental place alongside radiotherapy in the treatment of bulky mediastinal HD. Combined modality treatment improves the disease-free survival obtained with radiotherapy or chemotherapy alone. In our experience a high percentage of patients (83%) can be considered cured without the need for second-line therapy. However, long-term and especially gonadal toxicity greatly influence the quality of life of these patients. Therefore treatment must be personalized according to age, sex, cardiopulmonary status and desire to preserve reproductive function.|
|M De Lena; P Ditonno; V Lorusso; A Timurian; A Pellecchia; M Brandi; F Berardi; F Marzullo|
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|Type: Clinical Trial; Journal Article|
|Title: Haematologica Volume: 78 ISSN: 0390-6078 ISO Abbreviation: Haematologica Publication Date: 1993 Jul-Aug|
|Created Date: 1994-02-28 Completed Date: 1994-02-28 Revised Date: 2010-03-24|
Medline Journal Info:
|Nlm Unique ID: 0417435 Medline TA: Haematologica Country: ITALY|
|Languages: eng Pagination: 230-5 Citation Subset: IM|
|Division of Medical Oncology, Oncology Institute, Bari, Italy.|
|APA/MLA Format Download EndNote Download BibTex|
Antineoplastic Combined Chemotherapy Protocols / adverse effects, therapeutic use*
Bleomycin / administration & dosage, adverse effects
Combined Modality Therapy
Dacarbazine / administration & dosage, adverse effects
Doxorubicin / administration & dosage, adverse effects
Etoposide / administration & dosage
Hodgkin Disease / drug therapy, mortality, pathology, radiotherapy, therapy*
Infertility / etiology
Lomustine / administration & dosage
Mechlorethamine / administration & dosage, adverse effects
Mediastinal Neoplasms / drug therapy, mortality, pathology, radiotherapy, therapy*
Prednimustine / administration & dosage
Prednisone / administration & dosage, adverse effects
Procarbazine / administration & dosage, adverse effects
Radiotherapy, High-Energy* / adverse effects
Vincristine / administration & dosage, adverse effects
|0/ABVD protocol; 0/CEP protocol; 0/MOPP protocol; 11056-06-7/Bleomycin; 13010-47-4/Lomustine; 23214-92-8/Doxorubicin; 29069-24-7/Prednimustine; 33419-42-0/Etoposide; 4342-03-4/Dacarbazine; 51-75-2/Mechlorethamine; 53-03-2/Prednisone; 57-22-7/Vincristine; 671-16-9/Procarbazine; 865-21-4/Vinblastine|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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