Two cycles of MOPP and radiotherapy: effective treatment for stage IIIA and IIIB Hodgkin's disease.
Two cycles of MOPP (mechlorethamine, vincristine (Oncovin), procarbazine, prednisone) and radiotherapy were used to treat 197 patients with stage III Hodgkin's disease. Prior to 1980, radiotherapy was delivered to the mantle, abdomen and pelvis; thereafter, pelvic irradiation was deleted for patients with stage III1 disease. Complete remission rates for IIIA and IIIB presentations were 91% and 89%. The 10-year freedom from tumor mortality (FTM) rate for all patients was 81%; for IIIA, it was 87% and for IIIB, it was 72%. Results were not significantly affected by gender, age, pathology, or deletion of pelvic radiotherapy. However, a subgroup of 28 patients with a tumor burden that included pelvic disease who also had B symptoms was identified as having a poor prognosis. Their FTM was 43%, compared with 87% for all other patients combined (P = 0.002). Based on this analysis, we conclude that limited chemotherapy in combination with radiation therapy can yield results similar to programs that use more chemotherapy for all patients with IIIA disease and for most patients with stage IIIB. However, patients with tumor burdens which include pelvic disease and B symptoms require a different approach.
Hagemeister
F B
FB
Department of Hematology, University of Texas, M. D. Anderson Cancer Center, Houston.
Fuller
L M
LM
Velasquez
W S
WS
McLaughlin
P
P
Redman
J R
JR
Swan
F
F
Rodriguez
M A
MA
North
L
L
Dixon
D
D
Silvermintz
K
K
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D012008:Recurrence; D012074:Remission Induction; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D011241:Prednisone