Eich, Hans Theodor, Diehl, Volker, Goergen, Helen, Pabst, Thomas, Markova, Jana, Debus, Juergen, Ho, Anthony, Doerken, Bernd, Rank, Andreas, Grosu, Anca-Ligia, Wiegel, Thomas, Karstens, Johann Hinrich, Greil, Richard, Willich, Normann, Schmidberger, Heinz, Doehner, Hartmut, Borchmann, Peter, Mueller-Hermelink, Hans-Konrad, Mueller, Rolf-Peter and Engert, Andreas (2010). Intensified Chemotherapy and Dose-Reduced Involved-Field Radiotherapy in Patients With Early Unfavorable Hodgkin's Lymphoma: Final Analysis of the German Hodgkin Study Group HD11 Trial. J. Clin. Oncol., 28 (27). S. 4199 - 4207. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose Combined-modality treatment consisting of four to six cycles of chemotherapy followed by involved-field radiotherapy (IFRT) is the standard of care for patients with early unfavorable Hodgkin's lymphoma (HL). It is unclear whether treatment results can be improved with more intensive chemotherapy and which radiation dose needs to be applied. Patients and Methods Patients age 16 to 75 years with newly diagnosed early unfavorable HL were randomly assigned in a 2 x 2 factorial design to one of the following treatment arms: four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) + 30 Gy of IFRT; four cycles of ABVD + 20 Gy of IFRT; four cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP(baseline)) + 30 Gy of IFRT; or four cycles of BEACOPP(baseline) + 20 Gy of IFRT. Results With a total of 1,395 patients included, the freedom from treatment failure (FFTF) at 5 years was 85.0%, overall survival was 94.5%, and progression-free survival was 86.0%. BEACOPP(baseline) was more effective than ABVD when followed by 20 Gy of IFRT (5-year FFTF difference, 5.7%; 95% CI, 0.1% to 11.3%). However, there was no difference between BEACOPP(baseline) and ABVD when followed by 30 Gy of IFRT (5-year FFTF difference, 1.6%; 95% CI, -3.6% to 6.9%). Similar results were observed for the radiotherapy question; after four cycles of BEACOPP(baseline), 20 Gy was not inferior to 30 Gy (5-year FFTF difference, -0.8%; 95% CI, -5.8% to 4.2%), whereas inferiority of 20 Gy cannot be excluded after four cycles of ABVD (5-year FFTF difference, -4.7%; 95% CI, -10.3% to 0.8%). Treatment-related toxicity occurred more often in the arms with more intensive therapy. Conclusion Moderate dose escalation using BEACOPP(baseline) did not significantly improve outcome in early unfavorable HL. Four cycles of ABVD should be followed by 30 Gy of IFRT.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Eich, Hans TheodorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diehl, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goergen, HelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pabst, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Markova, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Debus, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ho, AnthonyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerken, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rank, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grosu, Anca-LigiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiegel, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karstens, Johann HinrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Greil, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willich, NormannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidberger, HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doehner, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borchmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller-Hermelink, Hans-KonradUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, Rolf-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engert, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-496497
DOI: 10.1200/JCO.2010.29.8018
Journal or Publication Title: J. Clin. Oncol.
Volume: 28
Number: 27
Page Range: S. 4199 - 4207
Date: 2010
Publisher: AMER SOC CLINICAL ONCOLOGY
Place of Publication: ALEXANDRIA
ISSN: 1527-7755
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
POSITRON-EMISSION-TOMOGRAPHY; INTERNATIONAL PROGNOSTIC SCORE; NODE RADIOTHERAPY; STAGE-I; DISEASE; CYCLES; PROGRESSION; RADIATION; SUPERIOR; THERAPYMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/49649

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