[The 1st results of the combined therapy of recurrent and refractory forms of lymphogranulomatosis (polychemotherapy, radiation therapy and the removal of the residual mediastinal formation)].
OBJECTIVE
To achieve a maximal complete remission rate in patients with recurrent and refractory Hodgkin's disease. To find out a group of patients in whom surgical removal of the residual mediastinal mass would be most effective.


METHODS
46 patients with Hodgkin's disease received Dexa-BEAM chemotherapy followed by radiotherapy. Surgical removal of the residual mediastinal mass was made in 12 patients.


RESULTS
Second-line Dexa-BEAM therapy produced a 50% complete remission rate. Overall survival was 45.5%, the disease-free survival--43.5%. Removed mediastinal masses were indicative of Hodgkin's disease in 7 cases and fibrosis in 4 cases.


CONCLUSIONS
Dexa-BEAM is an effective program in the treatment of recurrent and refractory Hodgkin's disease. Surgical removal of the residual mediastinal mass with radiotherapy and high-dose chemotherapy improves prognosis in very unfavorable, primary progressive form of Hodgkin's disease.
Stroiakovskiĭ
D L
DL
Pivnik
A V
AV
Shavlokhov
V S
VS
Sotnikov
V M
VM
Moiseeva
T N
TN
Rasstrigin
N A
NA
Margolin
O V
OV
Efimov
I V
IV
Dzhumabaeva
B T
BT
Kaplanskaia
I B
IB
Roshchina
L S
LS
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery*; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D018365:Neoplasm, Residual; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*
D003561:Cytarabine; D005047:Etoposide; D003907:Dexamethasone; D008558:Melphalan; D002330:Carmustine