Chemotherapy Combined with Involved-Field Radiotherapy for 177 Children with Hodgkin's Disease Treated in 1983–1987

1991 ◽  
Vol 33 (6) ◽  
pp. 703-708 ◽  
Author(s):  
Walentyna Balwierz ◽  
Jerzy Armata ◽  
Angelina Moryl-Bujakowska ◽  
Teresa Depowska ◽  
Anna Najbar ◽  
...  
1983 ◽  
Vol 69 (5) ◽  
pp. 463-467
Author(s):  
Teodoro Chisesi ◽  
Orlando Ricciardi ◽  
Sandra Dal Fior ◽  
Francesco Cappellari ◽  
Franco Pozza ◽  
...  

Forty-nine patients with previously untreated advanced Hodgkin's disease were treated in our Institution between 1973 and 1981. Treatment modalities of these patients were reviewed, and they were divided into 3 groups according to the treatment employed: 13 patients received MOPP only, 22 patients received MOPP plus involved field radiotherapy, and 14 received alternating MOPP/ABVD chemotherapy. The response rates for the 3 groups were respectively 38.5%, 63.6% and 78.6%. A longer follow-up is needed to assess a significant difference in survival curves. The advantages of adjuvant radiotherapy and alternating non-cross-resistant drugs in advanced Hodgkin's disease are discussed.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1670-1670 ◽  
Author(s):  
Ranjana H Advani ◽  
Richard T Hoppe ◽  
David M. Baer ◽  
Joseph Mason ◽  
Saul A Rosenberg ◽  
...  

Abstract Abstract 1670 Poster Board I-696 The standard management for early stage Hodgkin's disease (HD) is combined modality therapy. In the G4 protocol, patients (pts) with non-bulky, supra-diaphragmatic stage I-IIA disease received 8 weeks of Stanford V chemotherapy + 30 Gy involved field radiotherapy (IFRT). 87 pts were enrolled and treated between 4/1996 and 4/2001. Median age was 30 years (16-59) and stages were IA (n=23), IIA (n=64). Unfavorable risk factors were present in 47 patients (54%) according to German Hodgkin Study Group (GHSG) criteria (> 2 AA sites, ESR > 50 or EN involvement) and 38 (44%) according to EORTC criteria (> 3 AA sites, ESR > 50). Therapy was well tolerated with grade 3-4 non-hematologic toxic events in 7 % of pts. These included constipation (n=3), peripheral neuropathy (n=1), generalized weakness (n=2), chest pain (n=1), mylagias (n=1), abdominal pain (n=1) and an allergic reaction to etoposide (n=1). 42 patients received cytokine support for grade 3-4 neutropenia however only 2 pts developed fever with neutropenia. No cases of clinical bleomycin toxicity or radiation pneumonitis were observed. At a median follow-up of 9 (2-12) years, freedom from progression (FFP) and survival (OS) are 94% and 96% respectively. FFP was 100% for favorable and 89% for unfavorable patients by GHSG criteria (p=0.04) with no differences in OS (96.9% versus 95.7%). All relapses (n=5) occurred in the RT field: limited in 2 patients and combined with distant disease in 3 pts. All relapses were in “unfavorable” risk patients: 5 per GHSG and 4 per EORTC criteria. Secondary therapy included chemotherapy followed by high dose therapy and stem cell support (n=3) and ABVD (n=2). Three pts died, 2 due to disease progression after second-line therapy and one due to metastatic colon cancer. 5 patients developed a second cancer (2 breast, 2 melanomas at unirradiated sites and 1 colon cancer). The cases of breast cancer were considered unrelated to RT as both occurred within 5-years of therapy in women who were > 30 yrs at time of treatment. No secondary AML and no late cardiac or pulmonary toxicities have been observed. In conclusion, for pts with non-bulky stage I/II A HD, abbreviated Stanford V with 8 weeks of chemotherapy and 30 Gy IFRT is a safe and highly effective regimen. It is still too early to assess potential RT-related complications. Our outcomes in “unfavorable” stage I-IIA patients without bulky or symptomatic disease compare favorably with more intensive or prolonged regimens employed by the GHSG and EORTC. Disclosures No relevant conflicts of interest to declare.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9035-9035 ◽  
Author(s):  
E. N. Ebeid ◽  
M. Zaghloul ◽  
M. Khairy

9035 Background: To assess clinical outcome of chemotherapy and involved field radiotherapy in all stages of pediatric Hodgkin’s Disease in rural areas of Egypt treated at Menya oncology centre which is located 300km south the capital. Methods: Between April 2000 and November 2005, 27 previously untreated patients were investigated, treated and analyzed for remission and survival. Results: There were 21 males and 6 girls with a median age of 11 years, 29.6% were less than 10 years, 70.3% had advanced stage disease (IIB-IV), bulky mediastinal mass in 19 cases spleen involvement in 6 cases, bone marrow aspirate was free in all cases, bone marrow biopsy was not done. patients with stage I and IIA received 2 courses of EOPA (etopsid, vincristine, prednisone and doxorubicin), patients with stage IIb and IIIa received 2 courses of EOPA and 2 courses of ECOP (etopsid, cyclophophamide, vincristine and prednisone), while patients with stage IIIb and IV received 2courses of EOPA and 4 courses of ECOP, All patients received involved field radiotherapy according to stage. Complete remission was achieved in 96.2%. Progressive disease in 1 (3.7%) which required change line of therapy. Out of the 27 patients 3 (11.1%) have relapsed (17, 22 and 25 months) post completion of chemotherapy and were treated with another line of chemotherapy. The 2 years DFS was 90.9% with 95% of CI (73%-100%). Treatment was given outpatient, with no supportive therapy or toxic deaths and no secondary malignancy from etopsid Conclusions: This regimen provides high rate of durable remission in rural areas of Egypt with limited resources (drugs availability and supportive measures). No significant financial relationships to disclose.


1997 ◽  
Vol 15 (4) ◽  
pp. 1583-1586 ◽  
Author(s):  
K C Stine ◽  
R L Saylors ◽  
J R Sawyer ◽  
D L Becton

PURPOSE To present two patients as illustrations of the risk of developing secondary acute myelogenous leukemia (sAML) when theoretically safe doses of etoposide (VP-16) are used. PATIENTS AND METHODS Patient no. 1 was a 15-year-old white girl diagnosed with stage IIa Hodgkin's disease. She was treated with a combination of vincristine, doxorubicin, bleomycin, and VP-16 (2 g/m2 total) over 4 months, followed by 25.5 Gy of involved-field radiotherapy. Patient no. 2 was an 11-year-old white boy diagnosed with virus-associated hemophagocytic syndrome (VAHS). He was treated with VP-16 intravenously (IV) and orally (0.3 g and 2.8 g/m2, respectively). RESULTS Patient no. 1 developed AML 16 months from the diagnosis of Hodgkin's disease. Patient no. 2 developed AML 26 months from diagnosis. Both bone marrows were consistent with French-American-British (FAB) M4 disease. Both patients had abnormalities of the long arm of chromosome 11. CONCLUSION The use of low-dose or oral VP-16 can be associated with the development of sAML. Clinicians should be cautious in the use of VP-16 in low-risk diseases.


1989 ◽  
Vol 26 (5) ◽  
pp. 525-525
Author(s):  
A Moryl-Bujakowska ◽  
W Balwierz ◽  
J Armata ◽  
T Depowska ◽  
U Radwanska ◽  
...  

1993 ◽  
Vol 11 (12) ◽  
pp. 2351-2361 ◽  
Author(s):  
A P Rapoport ◽  
J M Rowe ◽  
P A Kouides ◽  
R A Duerst ◽  
C N Abboud ◽  
...  

PURPOSE One hundred autotransplants for Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL) were examined prospectively to identify variables with prognostic significance. PATIENTS AND METHODS Ninety-six patients with relapsed or refractory HD or NHL underwent 100 autotransplants. Patients received high-dose carmustine (BCNU), etoposide, cytarabine, and cyclophosphamide (BEAC) followed by unpurged autologous stem-cell rescue. RESULTS The 3-year actuarial event-free survival (EFS) rate for the 47 HD patients is 49%, with a median followup duration of 2 years. For the 53 NHL patients, the 3-year actuarial EFS rate is 40%, with a median follow-up duration of 19 months. By multivariate analysis, minimal disease on admission (all areas < or = 2 cm) is associated with improved EFS (HD, P = .003, NHL, P = .03). The projected EFS rate for HD patients entering with minimal disease is 70% versus 15% for patients with bulky disease (P = .0001). The projected EFS rate for NHL patients with minimal disease is 48% versus 25% for patients with bulky disease (P = .04). Posttransplant involved-field radiotherapy, administered to 26 of the last 61 patients, was associated with an improved EFS rate for NHL patients (P = .015). The BEAC regimen was well tolerated by patients who entered the study with minimal disease (mortality rate, < 5%), but caused significant toxicity in patients with bulky disease (mortality rate, 25%). CONCLUSION Disease burden before autotransplantation is an important predictor of regimen-related toxicity and EFS. Posttransplant involved-field radiotherapy may improve outcomes in select patients with NHL. The BEAC regimen is safe and effective, particularly for patients with minimal disease.


Author(s):  
R. Brasacchio ◽  
L. Constine ◽  
A. Rapoport ◽  
J. Rowe ◽  
S. Eberly ◽  
...  

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