Möglichkeiten einer Therapiereduktion bei Morbus Hodgkin: III. Kann die Polychemotherapie bei einer kombinierten Chemo-Strahlentherapie lokalisierter Stadien verringert werden?

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Abstract
The effectiveness of 3 and 6 cycles of MOPP (mechlorethamine, vincristine, procarbazine and prednisolone) as initial chemotherapy in 108 patients with Hodgkin''s disease at clinical stages II nA, IIB, IIIA and B was compared in 2 groups, one treated in 6 cycles (Oct. 1972-Dec. 1976) and the other in 3 cycles (Jan. 1977-Oct. 1979). The clinically complete remissions obtained by this schedule and findings at exploratory splenectomy were chosen as measures of effectiveness. The frequency of clinically complete remission was similar in both groups. In 96% (97% for the 2nd group) of patients in whom the 3 (6) MOPP cycles of cytostatic treatment achieved clinically complete remission, exploratory splenectomy failed to reveal any infradiaphragmatic involvement. In patients in stage IIA and IIB, primary cytostatic treatment probably can be reduced to 3 MOPP cycles. Exploratory splenectomy and prophylactic infradiaphragmatic radiotherapy can be omitted in these patients, if the 5% risk of infradiaphragmatic involvement is accepted. Splenectomy can also be omitted in patients in stage III, but not infradiaphragmatic radiotherapy, including that to the spleen.