6533b82afe1ef96bd128c1a4
RESEARCH PRODUCT
Response-guided ABVD chemotherapy plus involved-field radiation therapy for intermediate-stage Hodgkin lymphoma in the pre-positron emission tomography era: a Gruppo Italiano Studio Linfomi (GISL) prospective trial.
Luca BaldiniGiuseppina CalvarusoFrancesco AngrilliGiuseppe PolimenoStefano LuminariStefano MolicaPaolo G. GobbiVincenzo CalleaMassimo FedericoEmilio IannittoLuigi MarcheselliEliana Valentina LiardoMaura BrugiatelliMario PetriniGiovanni QuartaCaterina StelitanoViviana MinardiClaudio TripodoFrancesco MerliDaniele Vallisasubject
AdultMalemedicine.medical_specialtyCancer ResearchAdolescentDacarbazinemedicine.medical_treatmentEarly restagingVinblastineBleomycinYoung AdultAdolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Dacarbazine; Doxorubicin; Female; Hodgkin Disease; Humans; Male; Middle Aged; Neoplasm Staging; Positron-Emission Tomography; Prospective Studies; Vinblastine; Young AdultAntineoplastic Combined Chemotherapy ProtocolsMedicineHumansProspective StudiesStage (cooking)Prospective cohort studyAgedNeoplasm StagingChemotherapyAntineoplastic Combined Chemotherapy Protocolmedicine.diagnostic_testbusiness.industryGeneral MedicineHematologyMiddle AgedCombined Modality TherapyHodgkin DiseaseSurgeryVinblastineRadiation therapyDacarbazineProspective StudieABVDOncologyDoxorubicinErythrocyte sedimentation ratePositron-Emission TomographyFemaleRadiologybusinessmedicine.drugHumandescription
Abstract Purpose In the pre—positron emission tomography era, the Gruppo Italiano Studio Linfomi (GISL) investigated the feasibility and efficacy of a treatment based on a response-tailored number of doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) courses in 218 intermediate-stage Hodgkin lymphoma patients. Patients and Methods Patients with stage I/II showing at least one adverse prognostic factor and stage IIIA without adverse prognostic factors were recruited. Treatment included a first step of 3 ABVD courses, followed by an early-restaging. Patients in CR/CRu received 1 additional ABVD cycle, patients in PR received 3 more ABVD, and nonresponder patients went off study. Involved-field radiation therapy (RT) was recommended on chemotherapy completion. Results The median age was 30 years (range, 15-68 years) and 131 patients (61%) were female. Seven percent of patients were in stage I, 78% in stage II, and 15% in stage III; B-symptoms, bulky tumor and erythrocyte sedimentation rate > 30 were recorded in 20%, 26%, and 43% of cases, respectively. The CR/CRu rate was 62% at early restaging, 72% at the end of chemotherapy, and 95% following RT. With a median follow-up of 74 months (range, 6-193 months), 7-year overall survival, relapse-free survival, and freedom from treatment failure were 91.8% (95% CI, 86%-95.5%), 89.2% (95% CI, 82.8%-93.3%), and 81.8% (95% CI, 75.2%-86.7%), respectively. Patients in CR/CRu on early restaging, receiving 4 ABVD, had an excellent outcome with 7-year RFS and cause-specific survival similar to those of the late responders treated with 6 ABVD (RFS, 87.5% vs. 90.5% and CSS, 96.6% vs. 92.7%, respectively). Conclusion The response-guided ABVD program we report, based on standard clinical staging procedures, proved to be feasible and safe in patients with intermediate-stage Hodgkin lymphoma.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2009-01-01 | Clinical lymphomamyeloma |