Abstract : BACKGROUND Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) plus involved-field radiation thera
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Abstract : BACKGROUND Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) plus involved-field radiation therapy (IFRT) is the gold-standard treatment for early and advanced stages of Hodgkin lymphoma (HL). We evaluated the outcomes of patients according to prognosis at diagnosis and over time to determine who achieved complete remission (CR).|PATIENTS AND METHODS Treatment-naive patients under the age of 75 years at all stages of HL were eligible. The favorable group (FG) contained patients with stage IA-IIIA disease without bulky areas who achieved CR after the third cycle of ABVD. They received only IFRT at 25 Gy. Patients in the unfavorable group (UG) exhibited stages IIIB and IV HL. The UG also included all patients with bulky disease and the subset of the FG without CR after 3 cycles of ABVD ie slow responders (FGSR). The UG received 6 cycles of ABVD plus IFRT at 30 Gy to bulky areas at diagnosis or to those areas remaining positive after the third cycle of ABVD.|RESULTS In total 584 patients were evaluable 285 of them belonged to the FG and 299 to the UG. Rates of CR were 98 and 85 for the FG and the UG respectively (P lt .001). Sixty patients in the FG received 6 cycles of ABVD because they had not achieved CR after 3 cycles (ie the FGSR subgroup). The 5-year event-free survival rate was 89 for the FG 66 for the FGSR and 72 for the UG (P lt .001). The overall survival at 5 years was significantly better for the FG (98) than for the FGSR (87) and the UG (88 P lt .001).|CONCLUSION: Patients from the FG demonstrated excellent outcomes compared with those from the FGSR and UG, despite receiving less chemotherapy and fewer doses of IFRT.|
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