Augmented therapy of extensive Hodgkin's disease: Radiation to known disease or prolongation of induction chemotherapy did not improve survival- results of a cancer and leukemia group B study

Morton Coleman, Sameer Rafla, Kathleen J. Propert, Arvin Glicksman, Bruce Peterson, Nis Nissen, Kurt Brunner, James F. Holland, James R. Anderson, Arlan Gottlieb, Thomas Kaufman

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Purpose: This prospective randomized trial in extensive untreated Hodgkin's disease was undertaken to assess the potential benefit of augmented therapy (12 months chemotherapy or radiation to known disease) compared to standard 6 months chemotherapy. Patient and Methods: A total of 258 patients, mostly Stage IV, were randomized to four treatment regimens consisting of six cycles of CCNU, vinblastine, procarbazine, and prednisone (CVPP); 12 cycles of CVPP; six cycles of CVPP followed by 25 Gy radiotherapy; or three cycles CVPP, 25 Gy radiotherapy, and three cycles CVPP. Results: Complete remissions were achieved in 65% of all patients. A 58% overall 5-year survival rate was obtained. Relapses in irradiated areas of known disease occurred in only 6% of responding patients. There was, however, no statistical difference in response frequency, disease-free survival, or overall survival among the four regimens. Elderly patients responded less frequently. Conclusion: While radiotherapy provided control of local (known) disease, no impact on overall survival was apparent. Likewise, doubling the duration of chemotherapy did not improve response or survival. Augmentation of therapy with either radiotherapy or more chemotherapy in this study was of no benefit compared to the standard 6 months of treatment.

Original languageEnglish (US)
Pages (from-to)639-645
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume41
Issue number3
DOIs
StatePublished - Jun 1 1998

Bibliographical note

Funding Information:
This study was supported in part by grants from the National Cancer Institute (CA-07968) and grants from the Fund for Blood and Cancer Research and the Malvin Savin Memorial Fund. This study was conducted by the Cancer and Leukemia Group B and was supported by Public Health Service Grants from the National Cancer Institute of Health, and the Department of Health and Human Services. The following members participated in this study: Finsen Institute, Copenhagen, Denmark, Nis I. Nissen; Swiss Group, Inselspital, Bern, Franco Cavalli; Roswell Park Memorial Institute, Buffalo, NY, Edward S. Henderson (CA-02599); Cornell Medical Center, New York, NY, Richard T. Silver (CA-02599); Columbia University, New York, NY, Rose Ruth Ellison (CA-12011); Maimonides Hospital, New York, NY, Sameer Rafla (CA-25119); Bowman-Gray School of Medicine, Winston-Salem, NC, Robert Cooper (CA-03927); Long Island Jewish Medical Center, New Hyde Park, NY, Kanti Rai (CA-11028); Mount Sinai School of Medicine, New York, NY, James F. Holland (CA-04457); Rhode Island Hospital, Providence, RI, Louis Leone (CA-08025); University of Minnesota, Minneapolis, MN, Bruche Peterson (CA-16450); West Virginia University Medical Center, Morgantown, WV, Peter Raich (CA-28562); Dartmouth-Hitchcock Medical Center, Hanover, NH, Gibbons Cornwell (CA-04326); Wilmington Medical Center, Wilmington, DE, Irving Berkowitz (CA-37041); University of Missouri, Columbia, MO, Michael Perry (CA-12046); Walter Reed Army Medical Center, Washington, D.C., Raymond Weiss (CA-26806); Thomas Jefferson Medical Center, Philadelphia, PA, Farid Haurani (CA-05462); McGill Cancer Center, Montreal, Canada, J.L. Hutchinson (CA-31809); University of Maryland Cancer Center, Baltimore, MD, Joseph Aisner (CA-31983); Massachusetts General Hospital, Boston, MA, Robert Carey (CA-12449); University of North Carolina, Chapel Hill, NC, Robert Capizzi; University of California at San Diego, CA, Mark Green (CA-11789); Harvard School of Public Health, Boston, MA, James R. Anderson (CA-33601); and a grant from the T. J. Martell Foundation.

Keywords

  • Chemotherapy
  • Extensive
  • Hodgkin's disease
  • Prolonged
  • Radiation

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