title: Sequential chemotherapy (etoposide, vinblastine, and doxorubicin) and subtotal lymph node radiation for patients with localized Hodgkin disease and unfavorable prognostic features: A phase II Cancer and Leukemia Group B Study (9051).
abstract: BACKGROUND
  The aim of this study was to evaluate a regimen of sequential chemotherapy and radiotherapy for patients with Hodgkin disease.
  
  
  METHODS
  The Cancer and Leukemia Group B conducted a Phase II study of three cycles of etoposide, vinblastine, and doxorubicin (EVA) chemotherapy followed by subtotal lymph node radiation for patients with localized Hodgkin disease and unfavorable prognostic features. Fifty-nine patients were enrolled in the study. Fifty-three patients met all study eligibility criteria; 48 of them (91%) had mediastinal disease and 29 (55%) had bulky mediastinal disease.
  
  
  RESULTS
  A complete response (CR) occurred in 35 of the patients (66%). Of all patients who had CR, 26% had the CR after the chemotherapy and before the radiation, and 74% after the chemotherapy and radiation. Twenty percent of the patients who had CR experienced disease progression; in these patients, the progression was outside the radiotherapy field in the lung and involved widespread disease.
  
  
  CONCLUSIONS
  EVA offers a nonbleomycin-containing alternative for patients in whom preexisting pulmonary disease may be exacerbated by bleomycin and radiation therapy. EVA, as given in this study (in three cycles), was insufficient chemotherapy for patients who had disease in areas outside the radiation fields (occult disease).
authors.affiliation: Department of Radiation Oncology, Washington University, Barnes-Jewish Hospital, St. Louis, Missouri, USA.
authors.forename: T H
authors.initials: TH
authors.lastname: Wasserman
authors.forename: G R
authors.initials: GR
authors.lastname: Petroni
authors.forename: F E
authors.initials: FE
authors.lastname: Millard
authors.forename: C T
authors.initials: CT
authors.lastname: Chung
authors.forename: M
authors.initials: M
authors.lastname: Barcos
authors.forename: J L
authors.initials: JL
authors.lastname: Johnson
authors.forename: G P
authors.initials: GP
authors.lastname: Canellos
authors.forename: B A
authors.initials: BA
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000009:adverse effects; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007970:Leukopenia / Q000209:etiology; D008198:Lymph Nodes / Q000473:pathology / Q000528:radiation effects*; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D011379:Prognosis; D011879:Radiotherapy Dosage; D012074:Remission Induction; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D014747:Vinblastine; D005047:Etoposide; D004317:Doxorubicin