Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma
To present our long-term experience regarding the use of chemotherapy plus low-dose involved-field radiotherapy (IFRT) for clinical Stage I-IIA Hodgkin's lymphoma. We analyzed the data of 368 patients. Of these, 66 received mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and 3...
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| creator | Vassilakopoulos, Theodoros P. Angelopoulou, Maria K. Siakantaris, Marina P. Kontopidou, Flora N. Dimopoulou, Maria N. Kokoris, Styliani I. Kyrtsonis, Marie Christine Tsaftaridis, Panayiotis Karkantaris, Christos Anargyrou, Konstantinos Boutsis, Dimitrios E. Variamis, Eleni Michalopoulos, Thymios Boussiotis, Vassiliki A. Panayiotidis, Panayiotis Papavassiliou, Constantinos Pangalis, Gerassimos A. |
| description | To present our long-term experience regarding the use of chemotherapy plus low-dose involved-field radiotherapy (IFRT) for clinical Stage I-IIA Hodgkin's lymphoma.
We analyzed the data of 368 patients. Of these, 66 received mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and 302 received doxorubicin (or epirubicin), bleomycin, vinblastine, and dacarbazine [A(E)BVD]. Patients with complete remission or very good partial remission were scheduled for low-dose IFRT (≤3200 cGy).
The 10-year failure-free survival (FFS) and overall survival (OS) rate was 85% and 86%, respectively. A(E)BVD-treated patients had superior 10-year FFS and OS rates compared with MOPP-treated patients (87% vs. 75%,
p = 0.009; and 93% vs. 71%,
p = 0.0004, respectively). Only 10 of 41 relapses had any infield (irradiated) component. Of the complete responders/very good partial responders treated with low-dose IFRT, those who received |
| doi_str_mv | 10.1016/j.ijrobp.2003.11.029 |
| format | Article |
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We analyzed the data of 368 patients. Of these, 66 received mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and 302 received doxorubicin (or epirubicin), bleomycin, vinblastine, and dacarbazine [A(E)BVD]. Patients with complete remission or very good partial remission were scheduled for low-dose IFRT (≤3200 cGy).
The 10-year failure-free survival (FFS) and overall survival (OS) rate was 85% and 86%, respectively. A(E)BVD-treated patients had superior 10-year FFS and OS rates compared with MOPP-treated patients (87% vs. 75%,
p = 0.009; and 93% vs. 71%,
p = 0.0004, respectively). Only 10 of 41 relapses had any infield (irradiated) component. Of the complete responders/very good partial responders treated with low-dose IFRT, those who received <2800 cGy had inferior FFS but similar OS as those who received 2800–3200 cGy. Adverse prognostic factors for FFS included age ≥45 years, leukocytosis ≥10 × 10
9/L, and extranodal extension. Secondary acute leukemia developed after MOPP with or without salvage therapy (
n = 6) or after ABVD plus salvage therapy (
n = 2). None of the nine secondary solid tumors developed within the RT fields.
IFRT at a dose of 2800–3000 cGy is highly effective in clinical Stage I-IIA HL patients who achieved a complete response or very good partial response with A(E)BVD. The long-term toxicity with respect to secondary malignancies appears to be acceptable.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2003.11.029</identifier><identifier>PMID: 15183480</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[ABVD ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Bleomycin - administration & dosage ; Combined Modality Therapy ; Dacarbazine - administration & dosage ; Disease-Free Survival ; Doxorubicin - administration & dosage ; Early stage ; Epirubicin - administration & dosage ; Female ; Hodgkin Disease - drug therapy ; Hodgkin Disease - pathology ; Hodgkin Disease - radiotherapy ; Hodgkin's lymphoma ; Humans ; Male ; Mechlorethamine - administration & dosage ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Neoplasms, Second Primary - etiology ; Prednisone - administration & dosage ; Procarbazine - administration & dosage ; Prognosis ; Radiotherapy ; Radiotherapy Dosage ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Recurrence ; Remission Induction ; Technology. Biomaterials. Equipments. Material. Instrumentation ; Treatment Outcome ; Vinblastine - administration & dosage ; Vincristine - administration & dosage]]></subject><ispartof>International journal of radiation oncology, biology, physics, 2004-07, Vol.59 (3), p.765-781</ispartof><rights>2004 Elsevier Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-e382748393380e19dfe270c4957c6c74e03b6e22ab96f5ee5c6c9546f511dd643</citedby><cites>FETCH-LOGICAL-c465t-e382748393380e19dfe270c4957c6c74e03b6e22ab96f5ee5c6c9546f511dd643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301603023241$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15862637$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15183480$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vassilakopoulos, Theodoros P.</creatorcontrib><creatorcontrib>Angelopoulou, Maria K.</creatorcontrib><creatorcontrib>Siakantaris, Marina P.</creatorcontrib><creatorcontrib>Kontopidou, Flora N.</creatorcontrib><creatorcontrib>Dimopoulou, Maria N.</creatorcontrib><creatorcontrib>Kokoris, Styliani I.</creatorcontrib><creatorcontrib>Kyrtsonis, Marie Christine</creatorcontrib><creatorcontrib>Tsaftaridis, Panayiotis</creatorcontrib><creatorcontrib>Karkantaris, Christos</creatorcontrib><creatorcontrib>Anargyrou, Konstantinos</creatorcontrib><creatorcontrib>Boutsis, Dimitrios E.</creatorcontrib><creatorcontrib>Variamis, Eleni</creatorcontrib><creatorcontrib>Michalopoulos, Thymios</creatorcontrib><creatorcontrib>Boussiotis, Vassiliki A.</creatorcontrib><creatorcontrib>Panayiotidis, Panayiotis</creatorcontrib><creatorcontrib>Papavassiliou, Constantinos</creatorcontrib><creatorcontrib>Pangalis, Gerassimos A.</creatorcontrib><title>Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>To present our long-term experience regarding the use of chemotherapy plus low-dose involved-field radiotherapy (IFRT) for clinical Stage I-IIA Hodgkin's lymphoma.
We analyzed the data of 368 patients. Of these, 66 received mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and 302 received doxorubicin (or epirubicin), bleomycin, vinblastine, and dacarbazine [A(E)BVD]. Patients with complete remission or very good partial remission were scheduled for low-dose IFRT (≤3200 cGy).
The 10-year failure-free survival (FFS) and overall survival (OS) rate was 85% and 86%, respectively. A(E)BVD-treated patients had superior 10-year FFS and OS rates compared with MOPP-treated patients (87% vs. 75%,
p = 0.009; and 93% vs. 71%,
p = 0.0004, respectively). Only 10 of 41 relapses had any infield (irradiated) component. Of the complete responders/very good partial responders treated with low-dose IFRT, those who received <2800 cGy had inferior FFS but similar OS as those who received 2800–3200 cGy. Adverse prognostic factors for FFS included age ≥45 years, leukocytosis ≥10 × 10
9/L, and extranodal extension. Secondary acute leukemia developed after MOPP with or without salvage therapy (
n = 6) or after ABVD plus salvage therapy (
n = 2). None of the nine secondary solid tumors developed within the RT fields.
IFRT at a dose of 2800–3000 cGy is highly effective in clinical Stage I-IIA HL patients who achieved a complete response or very good partial response with A(E)BVD. The long-term toxicity with respect to secondary malignancies appears to be acceptable.</description><subject>ABVD</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bleomycin - administration & dosage</subject><subject>Combined Modality Therapy</subject><subject>Dacarbazine - administration & dosage</subject><subject>Disease-Free Survival</subject><subject>Doxorubicin - administration & dosage</subject><subject>Early stage</subject><subject>Epirubicin - administration & dosage</subject><subject>Female</subject><subject>Hodgkin Disease - drug therapy</subject><subject>Hodgkin Disease - pathology</subject><subject>Hodgkin Disease - radiotherapy</subject><subject>Hodgkin's lymphoma</subject><subject>Humans</subject><subject>Male</subject><subject>Mechlorethamine - administration & dosage</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Neoplasms, Second Primary - etiology</subject><subject>Prednisone - administration & dosage</subject><subject>Procarbazine - administration & dosage</subject><subject>Prognosis</subject><subject>Radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Recurrence</subject><subject>Remission Induction</subject><subject>Technology. Biomaterials. Equipments. Material. Instrumentation</subject><subject>Treatment Outcome</subject><subject>Vinblastine - administration & dosage</subject><subject>Vincristine - administration & dosage</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFq3DAQhkVpabZp36AEXZqe7EiWLFuXQFjaphDopYHehCyNs9rIkiN5N-zbV2GXtqeeZhi--Wf4EPpISU0JFVfb2m1THOa6IYTVlNakka_QivadrFjb_nqNVoQJUrECn6F3OW8JIZR2_C06oy3tGe_JCoV1nAYX9OJiwGYDU1w2kPR8wLPfZezjc2VjBuzCPvo92Gp04C1O2ro_5BgTBp38ARvvgjPa47zoB8C30T48uvC55BymeRMn_R69GbXP8OFUz9H91y8_17fV3Y9v39c3d5Xhol0qYH3T8Z5JxnoCVNoRmo4YLtvOCNNxIGwQ0DR6kGJsAdoylS0vPaXWCs7O0eUxd07xaQd5UZPLBrzXAeIuKypLlGxEAfkRNCnmnGBUc3KTTgdFiXrxrLbq6Fm9eFaUquK5rF2c8nfDBPbv0klsAT6dAJ2LkDHpYFz-h-tFud4V7vrIQbGxd5BUNg6CAesSmEXZ6P7_yW9EY59U</recordid><startdate>20040701</startdate><enddate>20040701</enddate><creator>Vassilakopoulos, Theodoros P.</creator><creator>Angelopoulou, Maria K.</creator><creator>Siakantaris, Marina P.</creator><creator>Kontopidou, Flora N.</creator><creator>Dimopoulou, Maria N.</creator><creator>Kokoris, Styliani I.</creator><creator>Kyrtsonis, Marie Christine</creator><creator>Tsaftaridis, Panayiotis</creator><creator>Karkantaris, Christos</creator><creator>Anargyrou, Konstantinos</creator><creator>Boutsis, Dimitrios E.</creator><creator>Variamis, Eleni</creator><creator>Michalopoulos, Thymios</creator><creator>Boussiotis, Vassiliki A.</creator><creator>Panayiotidis, Panayiotis</creator><creator>Papavassiliou, Constantinos</creator><creator>Pangalis, Gerassimos A.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20040701</creationdate><title>Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma</title><author>Vassilakopoulos, Theodoros P. ; Angelopoulou, Maria K. ; Siakantaris, Marina P. ; Kontopidou, Flora N. ; Dimopoulou, Maria N. ; Kokoris, Styliani I. ; Kyrtsonis, Marie Christine ; Tsaftaridis, Panayiotis ; Karkantaris, Christos ; Anargyrou, Konstantinos ; Boutsis, Dimitrios E. ; Variamis, Eleni ; Michalopoulos, Thymios ; Boussiotis, Vassiliki A. ; Panayiotidis, Panayiotis ; Papavassiliou, Constantinos ; Pangalis, Gerassimos A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-e382748393380e19dfe270c4957c6c74e03b6e22ab96f5ee5c6c9546f511dd643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>ABVD</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bleomycin - administration & dosage</topic><topic>Combined Modality Therapy</topic><topic>Dacarbazine - administration & dosage</topic><topic>Disease-Free Survival</topic><topic>Doxorubicin - administration & dosage</topic><topic>Early stage</topic><topic>Epirubicin - administration & dosage</topic><topic>Female</topic><topic>Hodgkin Disease - drug therapy</topic><topic>Hodgkin Disease - pathology</topic><topic>Hodgkin Disease - radiotherapy</topic><topic>Hodgkin's lymphoma</topic><topic>Humans</topic><topic>Male</topic><topic>Mechlorethamine - administration & dosage</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Neoplasms, Second Primary - etiology</topic><topic>Prednisone - administration & dosage</topic><topic>Procarbazine - administration & dosage</topic><topic>Prognosis</topic><topic>Radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Recurrence</topic><topic>Remission Induction</topic><topic>Technology. Biomaterials. Equipments. Material. Instrumentation</topic><topic>Treatment Outcome</topic><topic>Vinblastine - administration & dosage</topic><topic>Vincristine - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vassilakopoulos, Theodoros P.</creatorcontrib><creatorcontrib>Angelopoulou, Maria K.</creatorcontrib><creatorcontrib>Siakantaris, Marina P.</creatorcontrib><creatorcontrib>Kontopidou, Flora N.</creatorcontrib><creatorcontrib>Dimopoulou, Maria N.</creatorcontrib><creatorcontrib>Kokoris, Styliani I.</creatorcontrib><creatorcontrib>Kyrtsonis, Marie Christine</creatorcontrib><creatorcontrib>Tsaftaridis, Panayiotis</creatorcontrib><creatorcontrib>Karkantaris, Christos</creatorcontrib><creatorcontrib>Anargyrou, Konstantinos</creatorcontrib><creatorcontrib>Boutsis, Dimitrios E.</creatorcontrib><creatorcontrib>Variamis, Eleni</creatorcontrib><creatorcontrib>Michalopoulos, Thymios</creatorcontrib><creatorcontrib>Boussiotis, Vassiliki A.</creatorcontrib><creatorcontrib>Panayiotidis, Panayiotis</creatorcontrib><creatorcontrib>Papavassiliou, Constantinos</creatorcontrib><creatorcontrib>Pangalis, Gerassimos A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vassilakopoulos, Theodoros P.</au><au>Angelopoulou, Maria K.</au><au>Siakantaris, Marina P.</au><au>Kontopidou, Flora N.</au><au>Dimopoulou, Maria N.</au><au>Kokoris, Styliani I.</au><au>Kyrtsonis, Marie Christine</au><au>Tsaftaridis, Panayiotis</au><au>Karkantaris, Christos</au><au>Anargyrou, Konstantinos</au><au>Boutsis, Dimitrios E.</au><au>Variamis, Eleni</au><au>Michalopoulos, Thymios</au><au>Boussiotis, Vassiliki A.</au><au>Panayiotidis, Panayiotis</au><au>Papavassiliou, Constantinos</au><au>Pangalis, Gerassimos A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2004-07-01</date><risdate>2004</risdate><volume>59</volume><issue>3</issue><spage>765</spage><epage>781</epage><pages>765-781</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>To present our long-term experience regarding the use of chemotherapy plus low-dose involved-field radiotherapy (IFRT) for clinical Stage I-IIA Hodgkin's lymphoma.
We analyzed the data of 368 patients. Of these, 66 received mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and 302 received doxorubicin (or epirubicin), bleomycin, vinblastine, and dacarbazine [A(E)BVD]. Patients with complete remission or very good partial remission were scheduled for low-dose IFRT (≤3200 cGy).
The 10-year failure-free survival (FFS) and overall survival (OS) rate was 85% and 86%, respectively. A(E)BVD-treated patients had superior 10-year FFS and OS rates compared with MOPP-treated patients (87% vs. 75%,
p = 0.009; and 93% vs. 71%,
p = 0.0004, respectively). Only 10 of 41 relapses had any infield (irradiated) component. Of the complete responders/very good partial responders treated with low-dose IFRT, those who received <2800 cGy had inferior FFS but similar OS as those who received 2800–3200 cGy. Adverse prognostic factors for FFS included age ≥45 years, leukocytosis ≥10 × 10
9/L, and extranodal extension. Secondary acute leukemia developed after MOPP with or without salvage therapy (
n = 6) or after ABVD plus salvage therapy (
n = 2). None of the nine secondary solid tumors developed within the RT fields.
IFRT at a dose of 2800–3000 cGy is highly effective in clinical Stage I-IIA HL patients who achieved a complete response or very good partial response with A(E)BVD. The long-term toxicity with respect to secondary malignancies appears to be acceptable.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15183480</pmid><doi>10.1016/j.ijrobp.2003.11.029</doi><tpages>17</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2004-07, Vol.59 (3), p.765-781 |
| issn | 0360-3016 1879-355X |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | ABVD Adolescent Adult Aged Aged, 80 and over Analysis of Variance Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Bleomycin - administration & dosage Combined Modality Therapy Dacarbazine - administration & dosage Disease-Free Survival Doxorubicin - administration & dosage Early stage Epirubicin - administration & dosage Female Hodgkin Disease - drug therapy Hodgkin Disease - pathology Hodgkin Disease - radiotherapy Hodgkin's lymphoma Humans Male Mechlorethamine - administration & dosage Medical sciences Middle Aged Neoplasm Staging Neoplasms, Second Primary - etiology Prednisone - administration & dosage Procarbazine - administration & dosage Prognosis Radiotherapy Radiotherapy Dosage Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Remission Induction Technology. Biomaterials. Equipments. Material. Instrumentation Treatment Outcome Vinblastine - administration & dosage Vincristine - administration & dosage |
| title | Combination chemotherapy plus low-dose involved-field radiotherapy for early clinical stage Hodgkin's lymphoma |
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