A randomised study of adjuvant MVPP chemotherapy after mantle radiotherapy in pathologically staged IA–IIB Hodgkin’s disease: 10-year follow-up

Purpose: Long-term follow-up of residual mediastinal masses in treated Hodgkin's disease using MR imaging. Material and Methods: Ten patients, with substantial residual mediastinal masses of low signal intensity (SI) in the T2-weighted image (T2WI), were reinvestigated with MR 19–79 months after completing treatment of Hodgkin's disease. All patients were in complete remission. Results: During the follow-up period, the masses had decreased in size by 0–95% (median 67%) as compared to their initial post-therapy size. The SI continued to be low in the T2WI and was unaffected by the degree of size reduction. Conclusion: It is speculated that these mainly fibrotic residual masses undergo slow degradation of the fibrotic part and/or resorption of remaining inflammatory tissue. It is important to understand the natural, long-term MR imaging changes of these residual masses in order more easily to recognize tumour recurrence or other pathologic conditions.

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Randomised study of MOPP (mustine, Oncovin, procarbazine,prednisone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease

Radiotherapy and Oncology ◽

10.1016/s0167-8140(86)80032-9 ◽

1986 ◽

Vol 7 (3) ◽

pp. 215-221 ◽

Cited By ~ 23

Author(s):

B.W. Hancock

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Randomised Study ◽

Advanced Hodgkin’S Disease

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Patients with Hodgkin's disease have too many follow up visits

BMJ ◽

10.1136/bmj.314.7077.0d ◽

1997 ◽

Vol 314 (7077) ◽

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease

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Results of a Prospective Trial of Mantle Irradiation Alone for Selected Patients With Early-Stage Hodgkin’s Disease

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.3.736 ◽

2001 ◽

Vol 19 (3) ◽

pp. 736-741 ◽

Cited By ~ 12

Author(s):

Kendall H. Backstrand ◽

Andrea K. Ng ◽

Ronald W. Takvorian ◽

Ellen L. Jones ◽

David C. Fisher ◽

...

Keyword(s):

Hodgkin's Disease ◽

Early Stage ◽

Hodgkin’S Disease ◽

Clinical Stage ◽

Prospective Trial ◽

Stage I ◽

Mixed Cellularity ◽

European Organization ◽

Extended Field

PURPOSE: To determine the efficacy of mantle radiation therapy alone in selected patients with early-stage Hodgkin’s disease. PATIENTS AND METHODS: Between October 1988 and June 2000, 87 selected patients with pathologic stage (PS) IA to IIA or clinical stage (CS) IA Hodgkin’s disease were entered onto a single-arm prospective trial of treatment with mantle irradiation alone. Eighty-three of 87 patients had ≥ 1 year of follow-up after completion of mantle irradiation and were included for analysis in this study. Thirty-seven patients had PS IA, 40 had PS IIA, and six had CS IA disease. Histologic distribution was as follows: nodular sclerosis (n = 64), lymphocyte predominant (n = 15), mixed cellularity (n = 3), and unclassified (n = 1). Median follow-up time was 61 months. RESULTS: The 5-year actuarial rates of freedom from treatment failure (FFTF) and overall survival were 86% and 100%, respectively. Eleven of 83 patients relapsed at a median time of 27 months. Nine of the 11 relapses contained at least a component below the diaphragm. All 11 patients who developed recurrent disease were alive without evidence of Hodgkin’s disease at the time of last follow-up. The 5-year FFTF in the 43 stage I patients was 92% compared with 78% in the 40 stage II patients (P = .04). Significant differences in FFTF were not seen by histology (P = .26) or by European Organization for Research and Treatment of Cancer H-5F eligibility (P = .25). CONCLUSION: Mantle irradiation alone in selected patients with early-stage Hodgkin’s disease is associated with disease control rates comparable to those seen with extended field irradiation. The FFTF is especially favorable among stage I patients.

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MOPP/ABV hybrid chemotherapy for advanced Hodgkin's disease significantly improves failure-free and overall survival: the 8-year results of the intergroup trial.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.1.19 ◽

1998 ◽

Vol 16 (1) ◽

pp. 19-26 ◽

Cited By ~ 75

Author(s):

J H Glick ◽

M L Young ◽

D Harrington ◽

R L Schilsky ◽

T Beck ◽

...

Keyword(s):

Overall Survival ◽

Relative Risk ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Myelogenous Leukemia ◽

Life Threatening ◽

Acute Myelogenous ◽

First Relapse ◽

Sequential Regimen

PURPOSE To compare the efficacy of sequential mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) followed by doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) versus the MOPP/ABV hybrid regimen in advanced-stage Hodgkin's disease. PATIENTS AND METHODS A total of 737 patients with previously untreated stages III2A, IIIB, IVA, or IVB Hodgkin's disease and patients in first relapse after radiotherapy were prospectively randomized to sequential MOPP-ABV or MOPP/ABV hybrid. Of 691 eligible patients, 344 received the sequential regimen and 347 received the hybrid. RESULTS The overall response rate was 95%, with complete responses (CRs) in 79%: 83% on the MOPP/ABV hybrid and 75% on the sequential MOPP-ABVD arm (P = .02). With a median follow-up time of 7.3 years, the 8-year failure-free survival (FFS) rates were 64% for MOPP/ABV hybrid and 54% far sequential MOPP-ABVD (P = .01; 0.69 relative risk of failure, comparing MOPP/ABV hybrid v MOPP-ABVD). The 8-year overall survival rate was significantly better for the MOPP/ABV hybrid (79%) as compared with sequential MOPP-ABVD (71%) (P = .02; relative risk, 0.65). MOPP/ABV hybrid had significantly more life-threatening or fatal neutropenia and pulmonary toxicity than the sequential MOPP-ABVD arm, which was associated with significantly greater thrombocytopenia. Nine cases of acute myelogenous leukemia or myelodysplasia were reported on the sequential regimen as compared with only one on the hybrid (P = .01). CONCLUSION MOPP/ABV hybrid chemotherapy was significantly more effective than sequential MOPP-ABVD. FFS and overall survival were significantly improved on the hybrid arm, which was also associated with a lower incidence of acute leukemia or myelodysplasia.

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Stanford V and Radiotherapy for Locally Extensive and Advanced Hodgkin’s Disease: Mature Results of a Prospective Clinical Trial

Journal of Clinical Oncology ◽

10.1200/jco.2002.20.3.630 ◽

2002 ◽

Vol 20 (3) ◽

pp. 630-637 ◽

Cited By ~ 31

Author(s):

Sandra J. Horning ◽

Richard T. Hoppe ◽

Sheila Breslin ◽

Nancy L. Bartlett ◽

B. William Brown ◽

...

Keyword(s):

Hodgkin's Disease ◽

Chemotherapy Regimen ◽

Hodgkin’S Disease ◽

Prognostic Score ◽

Secondary Leukemia ◽

Bulky Disease ◽

Standard Doxorubicin ◽

Splenic Disease ◽

Advanced Hodgkin’S Disease

PURPOSE: To provide more mature data on the efficacy and complications of a brief, dose-intense chemotherapy regimen plus radiation therapy (RT) to bulky disease sites for locally extensive and advanced-stage Hodgkin’s disease. PATIENTS AND METHODS: One hundred forty-two patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin’s disease received Stanford V chemotherapy for 12 weeks followed by 36-Gy RT to initial sites of bulky (≥ 5 cm) or macroscopic splenic disease. Freedom from progression (FFP), overall survival (OS), and freedom from second relapse (FF2R) were determined using life-table estimates. Outcomes were analyzed according to the international prognostic score. Late effects of treatment were recorded in follow-up. RESULTS: With a median follow-up of 5.4 years, the 5-year FFP was 89% and the OS was 96%. No patient progressed during treatment, and there were no treatment-related deaths. FFP was significantly superior among patients with a prognostic score of 0 to 2 compared with those with a score of 3 and higher (94% v 75%, P < .0001). No secondary leukemia was observed. To date, there have been 42 pregnancies after treatment. Among 16 patients who relapsed, the FF2R was 69% at 5 years. CONCLUSION: These data confirm our preliminary report that Stanford V chemotherapy with RT to bulky disease sites is highly effective in locally extensive and advanced Hodgkin’s disease. It is most important to compare this approach with standard doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy in the ongoing intergroup trial (E2496) to determine whether Stanford V with or without RT represents a therapeutic advance.

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