Less Intense Treatment Found Effective for Hodgkin's
Fewer chemo cycles and less radiation results in similar survival, less toxic exposure
WEDNESDAY, Aug. 11 (HealthDay News) -- A less intense chemotherapy and radiation treatment regimen for patients with early-stage Hodgkin's lymphoma appears just as effective at five years as a more intensive and toxic regimen, according to research published in the Aug. 12 issue of the New England Journal of Medicine.
Andreas Engert, M.D., of the University of Cologne in Germany, and colleagues randomly assigned 1,370 newly diagnosed early-stage Hodgkin's lymphoma patients with favorable prognoses to either four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and subsequent 30 Gy of radiation therapy (group 1), four cycles of ABVD and subsequent 20 Gy of radiation therapy (group 2), two cycles of ABVD and subsequent 30 Gy of radiation therapy (group 3), or two cycles of ABVD and subsequent 20 Gy of radiation therapy (group 4).
The researchers found no significant differences in freedom from treatment failure or overall survival in the two chemotherapy regimens, for which the five-year freedom from treatment failure rates were 93 percent (four-cycle regimen) and 91.1 percent (two-cycle regimen), or in the two radiation regimens. Patients in the four-cycle, 30 Gy radiation group, however, experienced more adverse events and acute toxic effects related to treatment.
"In patients with early-stage Hodgkin's lymphoma and a favorable prognosis, treatment with two cycles of ABVD followed by 20 Gy of involved-field radiation therapy is as effective as, and less toxic than, four cycles of ABVD followed by 30 Gy of involved-field radiation therapy. Long-term effects of these treatments have not yet been fully assessed," the authors write.