ASH: Chemo Alone Improves Long-Term Hodgkin's Survival
Survival rates with ABVD alone higher than with treatment including subtotal nodal radiation
MONDAY, Dec. 12 (HealthDay News) -- In patients with stage IA or IIA Hodgkin's lymphoma, treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) alone improves long-term overall survival compared with treatment that includes subtotal nodal radiation therapy, according to a study published online Dec. 11 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.
Ralph M. Meyer, M.D., from the National Cancer Institute of Canada Clinical Trials Group in Kingston, and colleagues examined the rate of 12-year overall survival in 405 patients with stage IA or IIA non-bulky Hodgkin's lymphoma treated with ABVD alone, versus those treated with subtotal nodal radiation therapy, with or without ABVD therapy. Patients in the ABVD-arm received four to six cycles of ABVD. Low-risk patients in the radiation-arm received only radiation, and high-risk patients received two cycles of ABVD plus radiation therapy. Patients were followed for a median of 11.3 years.
The investigators found that the overall rate of survival at 12 years was 94 percent for patients randomized to ABVD alone, compared with 87 percent for those who received radiation therapy (hazard ratio [HR] for death with ABVD alone, 0.50). The rates of freedom from disease progression were 87 and 92 percent, respectively (HR for disease progression, 1.91; 95 percent confidence interval [CI], 0.99 to 3.69), whereas rates of event-free survival were 85 and 80 percent, respectively (HR for event, 0.88; 95 percent CI, 0.54 to 1.43).
"The rate of long-term survival is higher with ABVD alone than with treatment that includes subtotal nodal radiation therapy," the authors write.
Several of the study authors disclosed financial relationships with the pharmaceutical and biotechnology industries.