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Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial.
J Clin Oncol 2007; 25(23):3495-502JC

Abstract

PURPOSE

To investigate whether combined-modality treatment (CMT) with two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by extended-field radiotherapy (EF-RT) is superior to EF-RT alone in patients with early favorable Hodgkin's lymphoma (HL).

PATIENTS AND METHODS

Between 1993 and 1998, 650 patients with newly diagnosed, histology-proven HL in clinical stages IA to IIB without risk factors were enrolled onto this multicenter study and randomly assigned to receive 30 Gy EF-RT plus 10 Gy to the involved field (arm A) or two cycles of ABVD followed by the same radiotherapy (arm B). Results At a median observation time of 87 months, there was no difference between treatment arms in terms of complete response rate (arm A, 95%; arm B, 94%) and overall survival (at 7 years: arm A, 92%; arm B, 94%; P = .43). However, freedom from treatment failure was significantly different, with 7-year rates of 67% in arm A (95% CI, 61% to 73%) and 88% in arm B (95% CI, 84% to 92%; P <or= .0001). This was due mainly to significantly more relapses after EF-RT only (arm A, 22%; arm B, 3%). No patient treated with CMT experienced relapse before year 3. Relapses were treated mainly with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, or with the combination cyclophosphamide, vincristine, procarbazine, and prednisone/ABVD; treatment of relapse was significantly more successful in arm A than in arm B (P = .017). In total, there were 39 second malignancies, with 21 in arm A and 18 in arm B, respectively. The incidence was approximately 0.8% per year during years 2 to 9 and was highest in older patients (P < .0001) and those with "B" symptoms (P = .012).

CONCLUSION

CMT consisting of two cycles of ABVD plus EF-RT is more effective than EF-RT alone.

Authors+Show Affiliations

First Department of Internal Medicine, Coordination Center for Clinical Trials, and Department of Radiotherapy, University Hospital of Cologne, Cologne, Germany. a.engert@uni-koeln.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17606976

Citation

Engert, Andreas, et al. "Two Cycles of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine Plus Extended-field Radiotherapy Is Superior to Radiotherapy Alone in Early Favorable Hodgkin's Lymphoma: Final Results of the GHSG HD7 Trial." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 25, no. 23, 2007, pp. 3495-502.
Engert A, Franklin J, Eich HT, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007;25(23):3495-502.
Engert, A., Franklin, J., Eich, H. T., Brillant, C., Sehlen, S., Cartoni, C., ... Diehl, V. (2007). Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 25(23), pp. 3495-502.
Engert A, et al. Two Cycles of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine Plus Extended-field Radiotherapy Is Superior to Radiotherapy Alone in Early Favorable Hodgkin's Lymphoma: Final Results of the GHSG HD7 Trial. J Clin Oncol. 2007 Aug 10;25(23):3495-502. PubMed PMID: 17606976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial. AU - Engert,Andreas, AU - Franklin,Jeremy, AU - Eich,Hans Theodor, AU - Brillant,Corinne, AU - Sehlen,Susanne, AU - Cartoni,Claudio, AU - Herrmann,Richard, AU - Pfreundschuh,Michael, AU - Sieber,Markus, AU - Tesch,Hans, AU - Franke,Astrid, AU - Koch,Peter, AU - de Wit,Maike, AU - Paulus,Ursula, AU - Hasenclever,Dirk, AU - Loeffler,Markus, AU - Müller,Rolf-Peter, AU - Müller-Hermelink,Hans Konrad, AU - Dühmke,Eckhart, AU - Diehl,Volker, Y1 - 2007/07/02/ PY - 2007/7/4/pubmed PY - 2007/8/31/medline PY - 2007/7/4/entrez SP - 3495 EP - 502 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 25 IS - 23 N2 - PURPOSE: To investigate whether combined-modality treatment (CMT) with two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by extended-field radiotherapy (EF-RT) is superior to EF-RT alone in patients with early favorable Hodgkin's lymphoma (HL). PATIENTS AND METHODS: Between 1993 and 1998, 650 patients with newly diagnosed, histology-proven HL in clinical stages IA to IIB without risk factors were enrolled onto this multicenter study and randomly assigned to receive 30 Gy EF-RT plus 10 Gy to the involved field (arm A) or two cycles of ABVD followed by the same radiotherapy (arm B). Results At a median observation time of 87 months, there was no difference between treatment arms in terms of complete response rate (arm A, 95%; arm B, 94%) and overall survival (at 7 years: arm A, 92%; arm B, 94%; P = .43). However, freedom from treatment failure was significantly different, with 7-year rates of 67% in arm A (95% CI, 61% to 73%) and 88% in arm B (95% CI, 84% to 92%; P <or= .0001). This was due mainly to significantly more relapses after EF-RT only (arm A, 22%; arm B, 3%). No patient treated with CMT experienced relapse before year 3. Relapses were treated mainly with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, or with the combination cyclophosphamide, vincristine, procarbazine, and prednisone/ABVD; treatment of relapse was significantly more successful in arm A than in arm B (P = .017). In total, there were 39 second malignancies, with 21 in arm A and 18 in arm B, respectively. The incidence was approximately 0.8% per year during years 2 to 9 and was highest in older patients (P < .0001) and those with "B" symptoms (P = .012). CONCLUSION: CMT consisting of two cycles of ABVD plus EF-RT is more effective than EF-RT alone. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/17606976/Two_cycles_of_doxorubicin_bleomycin_vinblastine_and_dacarbazine_plus_extended_field_radiotherapy_is_superior_to_radiotherapy_alone_in_early_favorable_Hodgkin's_lymphoma:_final_results_of_the_GHSG_HD7_trial_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2006.07.0482?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -