Alternating chemotherapy and irradiation in the treatment of advanced Hodgkin's disease

Journal Article · Thu Feb 01 04:00:00 EST 1979 · Cancer; (United States)

DOI:https://doi.org/10.1002/1097-0142(197902)43:2<472::AID-CNCR2820430211>3.0.CO;2-W· OSTI ID:5368629

Hoppe, R T; Portlock, C S; Glatstein, E; Rosenberg, S A; Kaplan, H S

From July 1974 through April 1977, 25 patients with stage IIIB or III/sub s/B Hodgkins disease were entered into a prospective trial to assess the efficacy of a new combined modality treatment program. Patients received either MOP(P) (nitrogen mustard, vincristine, procarbazine and prednisone) or PAVe (procarbazine, 1-phenylalanine mustard and vinblastine). The radiation fields were total lymphoid and the usual dose was 4000 to 4400 rad. Patients initially were treated in a split course fashion with six drug cycles sandwiched around total lymphoid irradiation. To minimize the time that patients were without systemic therapy and to maximize the doses of chemotherapy, an alternating approach was subsequently adopted. The total lymphoid fields were divided into three regions and treatment to each was alternated with 2 cycles of chemotherapy until the entire program was complete. The duration of therapy ranged from nine to eighteen months. Patients in the split course group received an average of 65% of their calculated total drug doses and those in the alternating group received an average of 76.5%. The primary complication was hematologic, with mean lowest recorded white cell count of 2200/mm/sup 3/ and platelet count of 101,000/mm./sup 3/ Twenty-two of 25 patients achieved an initial complete remission and twenty remain free of disease with a median follow-up interval of 28 months. Actuarial survival for the entire group including a patient who died prior to the institution of therapy is 84%, while for those who achieved a complete remission it is 100%. Figures for freedom-from-relapse in the same groups are 79 and 90%, respectively. These results are compared to our previous experience using total lymphoid irradiation alone and total lymphoid irradiation followed by adjuvant MOP(P) chemotherapy. The alternating technique for combining chemotherapy and irradiation is feasible.

• Research Organization: Stanford Univ., CA
• OSTI ID: 5368629
• Journal Information: Cancer; (United States), Journal Name: Cancer; (United States) Vol. 43:2; ISSN CANCA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BLOOD COUNT
BODY
CARDIOVASCULAR SYSTEM
CHEMOTHERAPY
DIGESTIVE SYSTEM
DISEASES
EMBOLI
EXTERNAL IRRADIATION
GASTROINTESTINAL TRACT
HEART
HEMORRHAGE
HODGKINS DISEASE
INFLAMMATION
INTESTINAL ABSORPTION
IRRADIATION
LUNGS
LYMPHATIC SYSTEM
LYMPHOMAS
MEDICINE
MEMBRANES
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PARTIAL BODY IRRADIATION
PATHOLOGICAL CHANGES
PATIENTS
PERICARDIUM
PNEUMONITIS
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SEROUS MEMBRANES
SIDE EFFECTS
SYMPTOMS
THERAPY
UPTAKE