title: Early stage Hodgkin's disease: ten-year results of a non-randomised study with radiotherapy alone or combined with MOPP.
abstract: From September 1976 to June 1982, 201 consecutive patients with stage I (A and B)-IIA Hodgkin's disease were stratified in two groups according to prognostic factors. The F group included 116 patients with favourable presentation: they were staged with laparotomy and treated with subtotal or total nodal radiotherapy alone. The U group included 85 cases with unfavourable presentation who were staged by laparoscopy and treated with 3MOPP (mechlorethamine, vincristine, procarbazine, prednisone)-radiotherapy-3MOPP. At 10 years the F group showed a freedom from progression (FFP) of 71% with significant difference between stage I and II (85% vs. 59%; P = 0.003) and an overall survival of 84%. The results of the U group were: FFP 83%, overall survival 74%, and the findings were not influenced by stage. FFP in patients with bulky vs. not bulky lymphoma was 70% vs. 87% (P = 0.04). No secondary acute non-lymphocytic leukaemia developed among patients treated with radiotherapy and in continuous complete remission, while acute leukaemia occurred in the F group patients who received salvage chemotherapy (4 of 31 cases) and in the U group (3 of 85 cases). Present results confirm the usefulness of radiotherapy alone in favourable pathological stage IA. All other disease stages will require a different strategy that should consist of radiotherapy combined with short-term effective regimens, such as ABVD (doxorubicin, bleomycin, vinblastine and decarbazine) or VBM (vinblastine, bleomycin and methotrexate) to reduce the incidence of MOPP-associated gonadal dysfunction and leukaemogenesis.
authors.affiliation: Division of Medical Oncology A, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bonfante
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.forename: S
authors.initials: S
authors.lastname: Viviani
authors.forename: R
authors.initials: R
authors.lastname: Zucali
authors.forename: L
authors.initials: L
authors.lastname: Devizzi
authors.forename: M
authors.initials: M
authors.lastname: Zanini
authors.forename: J D
authors.initials: JD
authors.lastname: Tesoro Tess
authors.forename: P
authors.initials: P
authors.lastname: Valagussa
authors.forename: A
authors.initials: A
authors.lastname: Banfi
authors.forename: G
authors.initials: G
authors.lastname: Bonadonna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007938:Leukemia / Q000209:etiology; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011379:Prognosis; D016879:Salvage Therapy; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D011241:Prednisone