Improved 5-year survival in advanced Hodgkin's disease by combined modality approach

G. Bonadonna, A. Santoro, R. Zucali, P. Valagussa

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Combined chemotherapy-radiotherapy (RT) was tested in advanced Hodgkin's disease through a prospective randomized trial. The series comprises patients who were previously untreated (55) or who showed first relapse following primary RT (21). Combination chemotherapy consisted of six cycles of either MOPP or ABVD. Four to 6 weeks from the end of chemotherapy, complete plus partial responders ≥ 75% were irradiated. Subtotal or total nodal irradiation (3000-3500 rads) was given to untreated patients with nodal involvement. In patients with extranodal extent, 2000-2500 rads were delivered to all nodal and extranodal sites of pretreatment involvement except the bone marrow. Pathologic complete remission was similar in both treatment groups either after chemotherapy (MOPP 63%, ABVD 71.5%) or after chemotherapy plus RT (MOPP 93%, ABVD 96%) with no difference between patients with prior or no prior RT, with or without systemic symtoms, nodal or extranodal extension. At 4 years from the end of treatment, 86.7% of all complete responders remain alive and continuously disease-free with no difference in untreated groups between MOPP and ABVD, presence or absence of systemic symptoms, nodal or extranodal disease. Prior RT had an unfavorable effect on the relapse-free survival in the MOPP group but not in the ABVD group (p = 0.05). The 5-year overall survival from starting combined treatment was 88.8% for complete responders and 0% for non-complete responders. Chemotherapy-radiotherapy is confirmed to be a useful approach for advanced Hodgkin's disease, particularly in the presence of extranodal involvement, systemic symptoms, and nodular sclerosis.

Original languageEnglish
Pages (from-to)217-226
Number of pages10
JournalCancer Clinical Trials
Issue number3
Publication statusPublished - 1979

ASJC Scopus subject areas

  • Medicine(all)


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