CEBOPP/VIML Followed by Radiotherapy for Intermediate- and Advanced-Stage HD

Aim:
To improve treatment results and minimize acute and late toxicity in patients (pts) with intermediate- or advanced-stage Hodgkin’s disease. A combined modality treatment consisting of a response-adapted chemotherapy (CTX) and radiotherapy (RTX) was used.

Conclusions:
CEBOPP/VIML followed by RTX appears to be highly effective in achieving long-term EFS and OS in pts with intermediate- or advanced-stage Hodgkin’s disease.

Official Title

CEBOPP/VIML Followed by Radiotherapy for Intermediate- and Advanced-Stage Hodgkin’s Disease: A Long-Term Analysis.

Conditions

Study Type

Review long term follow up of patients treated on protocol.

Study Design

Patients:189 pts (53% males, 47% females) with a median age of 33 yrs (range 16-78) without prior treatment. Pt characteristics: 2% stage I, 54% stage II, 26% stage III, 18% stage IV disease. 48% B-symptoms, 87% bulky tumors (=/>5cm), 20% extranodal involvement, 14% spleen involvement, 65% high ESR, 31% abnormal LDH. Treatment:CEBOPP -( Cy,Epirubicin,Bleomycin,Procarbazine & Prednisolone) repeated every 3 wks. 3 cycles in all pts and 2 cycles in pts who were going to receive mediastinal irradiation.Pts with no residual tumor after 4 cycles, CEBOPP was continued for further cycles. In pts with progressive disease during treatment with CEBOPP or partial remission (PR) after 4 cycles, therapy was switched to VP-16 (130 mg/m2 d1,3,5), ifosfamide (1300 mg/m2+mesna d1-5), methotrexate (70 mg/m2+leucovorin rescue d1,5) (VIML) repeated every 3 wks for 2-4 cycles. CTX was followed by RTX (30 Gy, 40 Gy in case of bulky disease or residual tumor) predominantly given to IF in stage I-II and stage III disease with <3 involved regions.

Further Details

Results: An overall response rate of 99%, including 70% complete remissions & 29% partial remissions (residual tumor>2cm). With a median follow-up of 6 yrs, the probability of event-free survival (EFS) and overall survival (OS) for the entire group of pts is 82% and 87% at 10 yrs, respectively. The probability of EFS and OS for pts with intermediate stage (n=83) is 86% and 88% and for pts with advanced stage (n=106) 79% and 86%.

Study Start

Eligibility & Criteria

Indication: Hodgkin’s LymphomaInclusion criteria were intermediate stage (I-II with risk factor or IIIA without risk factor) or advanced stage (IIB or IIIA with risk factor or IIIB or IV).

Total Enrolment

Contact Details

M.R. Nowrousian et alAbstract 2675 ASH 2005University Hospital of Essen Medical School, Essen, Germany