Author/Editor     Aleman, Berthe MP; Raemaekers, John MM; Tirelli, Umberto; Bortolus, Roberto; van't Veer, Mars B; Lybeert, Marnix LM; Keuning, Jo J; Carde, Patrice; Tomšič, Radka; Vovk, Marjeta
Title     Involved-filed radiotherapy for advanced Hodgkin's lymphoma
Type     članek
Source     N Engl J Med
Vol. and No.     Letnik 348, št. 24
Publication year     2003
Volume     str. 2396-406
Language     eng
Abstract     BACKGROUND The use of involved-field radiotherapy after chemotherapy for advanced Hodgkin's lymphoma is controversial. METHODS We randomly assigned patients with previously untreated stage III or IV Hodgkin's lymphoma who were in complete remission after hybrid chemotherapy with mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine (MOPP-ABV) to receive either no further treatment or involved-field radiotherapy. Radiotherapy consisted of 24 Gy to all initially involved nodal areas and 16 to 24 Gy to all initially involved extranodal sites. Patients in partial remission were treated with 30 Gy to nodal areas and 18 to 24 Gy to extranodal sites. RESULTS Of 739 patients, 421 had a complete remission; 161 of these patients were assigned to no further treatment, and 172 to involved-field radiotherapy. The median follow-up was 79 months. The five-year event-free survival rate was 84 percent in the group that did not receive radiotherapy and 79 percent in the group that received involved-field radiotherapy (P=0.35). The five-year overall survival rates were 91 and 85 percent, respectively (P=0.07). Among the 250 patients in partial remission after chemotherapy, the five-year event-free and overall survival rates were 79 and 87 percent, respectively CONCLUSIONS Involved-field radiotherapy did not improve the outcome in patients with advanced stage Hodgkin's lymphoma who had a complete remission after MOPP-ABV chemotherapy. Radiotherapy may benefit patients with a partial response after chemotherapy.
Descriptors     HODGKIN'S DISEASE
ANTINEOPLASTIC AGENTS, COMBINED
BLEOMYCIN
DOXORUBICIN
MECHLORETHAMINE
AGE FACTORS
SEX FACTORS
COMBINED MODALITY THERAPY
NEOPLASM STAGING
NEOPLASMS, SECOND PRIMARY
PREDNISONE
PROCARBAZINE
REMISSION INDUCTION
VINCRISTINE
VINBLASTINE
SURVIVAL ANALYSIS