Massive mediastinal involvement in stage I-II Hodgkin's disease: response to combined modality treatment.
Thirty-seven patients with stage I-II Hodgkin's disease and massive mediastinal involvement, observed between June 1981 and November 1989, underwent combined modality treatment. This treatment included: 3 cycles of mechlorethamine, vincristine, procarbazine, and prednisone followed by mantle-field irradiation, and subsequently by 3 additional cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. Thirty-five (95%) patients achieved complete responses and only 2 (5%) had partial responses. All the complete responders are living and relapse-free at a median follow-up of 62 months; no major toxic reactions were recorded. These data suggest, as did those of other studies, that combined modality therapy is superior to either radiotherapy or chemotherapy alone for patients in stage I-II with bulky disease, especially in the mediastinum. In fact, in these particular patients, if adequately treated with a combination of chemotherapy and radiotherapy, the role of massive mediastinal involvement as a poor prognostic factor appears to be less significant.
Zinzani
P L
PL
Institute of Hematology L. e A. Seràgnoli, University of Bologna, Italy.
Mazza
P
P
Gherlinzoni
F
F
Bocchia
M
M
Fiacchini
M
M
Bendandi
M
M
Barbieri
E
E
Frezza
G
G
Neri
S
S
Aitini
E
E
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate