Clinical trials with intensive chemotherapy and radiotherapy in Hodgkin's disease

M. De Lena, S. Monfardini, G. Beretta

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The preliminary results of an intensive treatment program for Stages II B, III B, III(S), and IV Hodgkin's disease are reported. The study was designed to explore the possibility of treating malignant lymphomas by a technique similar to that successfully used in treating acute leukemia. The protocol included an induction phase with multiple drug combination followed by a consolidation phase with high energy irradiation (only for Stages II B, III B, III(S), and selected Stage IV patients). Maintenance therapy was carried out with sequential cyclic chemotherapy periodically interrupted by 1 cycle of reinduction. After observing the toxic and therapeutic results of a pilot study in which the induction was performed in 17 patients with quadruple chemotherapy (mechlorethamine, adriamycin, vincristine, and prednisone), the authors started a new trial in December 1970. The induction phase included 5 drugs: mechlorethamine, adriamycin, bleomycin, vincristine, and prednisone administered in 6 or 2 cycles. A total of 41 patients could be evaluated. Complete remission occurred in an average of 64% (68% after 6 cycles and 56% after 2 cycles). Complete remissions rose to 93% when partial plus complete responders were irradiated after induction chemotherapy. An adequate evaluation of the duration of complete remission is not yet available. Both incidence and degree of toxicity were acceptable, and only a small percentage of the patients required a drastically reduced dosage. Furthermore, patients splenectomized showed less leukopenia compared to those not splenectomized before therapy. About 20% of the patients had slight pulmonary toxicity induced by bleomycin. In all patients, toxic lesions were reversible.

Original languageEnglish
Title of host publicationNational Cancer Institute Monograph
Pages403-420
Number of pages18
Volumevol.36
Publication statusPublished - 1973

ASJC Scopus subject areas

  • Cancer Research
  • Medicine(all)

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