title: Three cycles of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or epirubicin, bleomycin, vinblastine, and methotrexate (EBVM) plus extended field radiation therapy in early and intermediate Hodgkin disease: 10-year results of a randomized trial.
abstract: From 1990 to 1996, a total of 386 adult patients with early/intermediate Hodgkin disease (HD) were randomly assigned to receive 3 cycles of adriamycin, bleomycin, vinblastine, dacarbazine (an alkylating agent), and methylprednisolone (ABVDm, arm A) or epirubicin, bleomycin, vinblastine, methotrexate, and methylprednisolone (EBVMm, arm E), a combination without alkylating agent. Responding patients received extended field radiation therapy (RT). Postchemotherapy complete remission and 10-year freedom from progression rates were higher in arm A (79.5% and 91.4%) than in arm E (70.4%, P =.04, and 80%, P <.002). HD mortality (HDM), treatment-related mortality (TRM), and overall survival (OS) were similar in both arms (A, 2.1%, 7.5%, and 90.4%; B, 3.9%, 5.5%, and 90.3%). However TRM and OS rates were lower in patients aged 40 years or older (P <.005), reflecting the increasing incidence of background fatal events with increasing age. Finally, event-free survival (EFS) was higher in arm A (84.6%) than in arm E (74.9%, P <.02). In patients aged younger than 40 years in arm A (74%), 10-year EFS and OS rates were 88.9% and 95.4% with HDM and TRM rates as low as 0.7% and 3%. Three courses of ABVDm plus RT are the best available option for treating early or intermediate HD.
authors.affiliation: Cancérologie médicale, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: le Maignan
authors.forename: Bernard
authors.initials: B
authors.lastname: Desablens
authors.forename: Vincent
authors.initials: V
authors.lastname: Delwail
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Dib
authors.forename: Christian
authors.initials: C
authors.lastname: Berthou
authors.forename: Magda
authors.initials: M
authors.lastname: Vigier
authors.forename: Christiane
authors.initials: C
authors.lastname: Ghandour
authors.forename: Said
authors.initials: S
authors.lastname: Atmani
authors.forename: Philippe
authors.initials: P
authors.lastname: Casassus
authors.forename: Herve
authors.initials: H
authors.lastname: Maisonneuve
authors.forename: Annick
authors.initials: A
authors.lastname: Le Mevel
authors.forename: Catherine
authors.initials: C
authors.lastname: Traulle
authors.forename: Marc
authors.initials: M
authors.lastname: Bernard
authors.forename: Josette
authors.initials: J
authors.lastname: Briere
authors.forename: Pierre
authors.initials: P
authors.lastname: Colonna
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Andrieu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005602:France / Q000453:epidemiology; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D014747:Vinblastine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D015251:Epirubicin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D008727:Methotrexate