Risk-Adapted Combined Radiotherapy and Chemotherapy for Hodgkin’s Disease – Results of a Pilot Study

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Abstract
Background: In an open pilot study we tested a program of reduced combined radio-chemotherapy in Hodgkin’s disease in limited stages with risk factors and in advanced stages. Aim of the study was to reduce the delayed complications of full-dose combined modality treatment while preserving its effectiveness. Material and Methods: From May 1985 to December 1988 43 previously untreated consecutive patients entered the study. Treatment consisted of CVPP/ABVCy hybrid chemotherapy and low-dose (25 Gy) involved-field radiotherapy. Results: All patients could be evaluated for response to treatment. Primary complete remission (CR) reached 35/43, partial remission 5/43 (12%), and 3/43 (7%) did not respond. After a median observation period of 64 months 28/35 (80%) are in first CR. The survival data are as follows: relapse-free survival 3 years 86%, 5 years 78%, overall survival 3 years 91%, 5 years 83% (Kaplan-Meier estimation). So far 7 patients relapsed and 7 patients died. The acute toxicity of the treatment program was acceptable and up to now we have not observed secondary neoplasms. Conclusions: We regard our treatment approach as useful; it matches the reports of other groups using similar treatment policies.

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