title: Long-term follow-up analysis of HD9601 trial comparing ABVD versus Stanford V versus MOPP/EBV/CAD in patients with newly diagnosed advanced-stage Hodgkin's lymphoma: a study from the Intergruppo Italiano Linfomi.
abstract: OBJECTIVE
  The Intergruppo Italiano Linfomi HD9601 trial compared doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) versus doxorubicin, vinblastine, mechloretamine, vincristine, bleomycin, etoposide, and prednisone (Stanford V [StV]) versus the combination of mechlorethamine, vincristine, procarbazine, prednisone (MOPP) with epidoxorubicin, bleomycin, vinblastine (EBV), lomustine, doxorubicin, and vindesine (CAD) (MOPP/EBV/CAD [MEC]) for the initial treatment of advanced-stage Hodgkin's lymphoma to select which regimen would best support a reduced radiotherapy program (limited to two or fewer sites of either previous bulky or partially remitting disease). Superiority of ABVD and MEC to StV was demonstrated. We report analysis of long-term outcome and toxicity.
  
  
  METHODS
  Patients with stage IIB, III, or IV were randomly assigned among six cycles of ABVD, three cycles of StV, and six cycles of MEC; radiotherapy was administered in 76, 71, and 50 patients in the three arms, respectively.
  
  
  RESULTS
  Currently, the median follow-up is 86 months; in the prolonged observation period, eight additional failures, including two relapses, both in the StV arm, and six additional deaths in complete response were recorded. The 10-year overall survival rates were 87%, 80%, and 78% for ABVD, MEC, and StV, respectively (P = .4). The 10-year failure-free survival was 75%, 74%, and 49% in the ABVD, MEC, and StV arms, respectively (P < .001). The 10-year disease-free survival of patients treated or not with radiotherapy (RT) showed no difference for ABVD or MEC (85% v 80% and 93% v 68%), and a statistically significant difference for StV (76% v 33%; P = .004). No significant long-term toxicity was recorded.
  
  
  CONCLUSIONS
  The long-term analysis confirmed ABVD and MEC superiority to StV. The use of RT after StV was established as mandatory. ABVD is still to be considered as the standard treatment with a good balance between efficacy and toxicity.
authors: Unità Operativa di Ematologia, Ospedale dell'Angelo AUSL 12 Venezia-Mestre-via Paccagnella, 11, 30174 Mestre-Venezia, Italy. OCVE.ematologia@ulss12.ve.it
authors: Teodoro
authors: T
authors: Chisesi
authors: Monica
authors: M
authors: Bellei
authors: Stefano
authors: S
authors: Luminari
authors: Antonella
authors: A
authors: Montanini
authors: Luigi
authors: L
authors: Marcheselli
authors: Alessandro
authors: A
authors: Levis
authors: Paolo
authors: P
authors: Gobbi
authors: Umberto
authors: U
authors: Vitolo
authors: Caterina
authors: C
authors: Stelitano
authors: Vincenzo
authors: V
authors: Pavone
authors: Francesco
authors: F
authors: Merli
authors: Marina
authors: M
authors: Liberati
authors: Luca
authors: L
authors: Baldini
authors: Roberto
authors: R
authors: Bordonaro
authors: Emanuela Anna
authors: EA
authors: Pesce
authors: Massimo
authors: M
authors: Federico
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D003606:Dacarbazine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D008130:Lomustine; D003606:Dacarbazine; D004317:Doxorubicin; D014751:Vindesine; D011241:Prednisone