Reduction of fatal complications from combined modality therapy in Hodgkin's disease.
A total of 464 pathologically staged IA through IIIB Hodgkin's disease patients were evaluated for the risk of developing acute nonlymphocytic leukemia, non-Hodgkin's lymphoma, or a fatal infection after treatment with radiation therapy (RT) alone, initial combined radiation therapy and chemotherapy (CMT), or RT with MOPP administered at relapse. Patients received a standard six cycles of MOPP, and additional maintenance chemotherapy was not administered. Patients receiving total nodal irradiation (TNI) and MOPP chemotherapy have an 11.9% actuarial risk of developing a fatal complication at ten years, as compared to a 0.8% risk for lesser field irradiation and MOPP (P = .005). The risk with RT alone is 0.6%. Patients 40 years of age or older have a greater risk for complications. These data report a low risk for fatal complication with CMT when less than TNI is administered and when maintenance chemotherapy is not used.
D000206:Actuarial Analysis; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007953:Leukemia, Radiation-Induced / Q000517:prevention & control; D008198:Lymph Nodes / Q000528:radiation effects*; D008466:Mechlorethamine / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000209:etiology / Q000517:prevention & control; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D011832:Radiation Injuries / Q000517:prevention & control*; D012306:Risk; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D011241:Prednisone