title: Three cycles of ABDV plus extended field radiotherapy in patients with poor prognosis early-intermediate stage Hodgkin's disease.
abstract: The aim of the study was to verify the possibility of treating patients with poor prognosis early-intermediate Hodgkin's disease with a combined modality therapy consisting of three cycles of ABVD followed by extended field irradiation (EFRT). No patient had bulky mediastinum or had previously been administered chemo- or radiotherapy. At pathological restaging, 40/44 (91%) evaluable patients achieved complete responses (CR). After a ten-year followup, freedom from progression (FFP), relapse-free survival (RFS) and overall survival (OS) were 80%, 83% and 81%, respectively. Of the prognostic factors, univariate analysis showed that only stage III negatively influenced RFS, but not OS. Toxicity was mild except for subclinical mediastinal fibrosis in 32.5% of CR patients. No patient reported reduced fertility. Two cases of second neoplasms were recorded: one ameboid glioma and one thymoma, both occurring within five years after discontinuing chemo-radiotherapy. Our data suggest that three cycles of ABVD preceeding EFRT is an effective treatment for poor prognosis early-intermediate stage Hodgkin's disease; nevertheless, stage III patients and some stage II patients with unfavorable prognostic factors should be treated with a more aggressive approach.
authors.affiliation: INST ONCOL,MED ONCOL OPERAT UNIT,BARI,ITALY. INST ONCOL,RADIOTHERAPY UNIT,BARI,ITALY. INST ONCOL,ENDOSCOPY UNIT,BARI,ITALY. INST ONCOL,RADIOL UNIT,BARI,ITALY. INST ONCOL,PATHOL UNIT,BARI,ITALY.
authors.forename: V
authors.initials: V
authors.lastname: Lorusso
authors.forename: A
authors.initials: A
authors.lastname: Timurian
authors.forename: M
authors.initials: M
authors.lastname: Brandi
authors.forename: A
authors.initials: A
authors.lastname: Pellecchia
authors.forename: A
authors.initials: A
authors.lastname: Cramarossa
authors.forename: F
authors.initials: F
authors.lastname: Marzullo
authors.forename: M
authors.initials: M
authors.lastname: Delena