Annals of Oncology 15:270-275, 2004
© 2004 European Society for Medical Oncology
Original Paper |
Comparison of MOPP versus ABVD as salvage therapy in patients who relapse after radiation therapy alone for Hodgkins disease
Received 17 September 2003; accepted 28 October 2003Background:
The aim of this study was to determine salvage outcome in patients with Hodgkins disease who relapse after radiation therapy, and to compare the efficacy of mechlorethamine, Oncovin, procarbazine and prednisone (MOPP) versus Adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) as salvage treatment.
Patients and methods:
One hundred patients with Hodgkins disease (97 with stage III disease at presentation) who relapsed after radiation therapy alone were salvaged with either MOPP or ABVD. Freedom from second relapse (FFSR) and overall survival (OS) were determined, and prognostic factors for salvage outcome were evaluated.
Results:
The median follow-up time since salvage therapy was 12 years. The 10-year FFSR and OS rates were 70% and 89%, respectively. Forty-one patients were salvaged with MOPP and 59 received ABVD. The type of salvage chemotherapy did not significantly influence FFSR or OS. Age >50 years at initial diagnosis was the only significant predictor for an inferior FFSR and OS on both univariate and multivariate analyses.
Conclusions:
The two salvage regimens of MOPP and ABVD had similar efficacy in this group of patients with predominantly early-stage disease at initial radiation therapy. The inferior salvage outcome in patients aged >50 years is a contributing factor to the overall poor prognosis of patients presenting with Hodgkins disease at an older age.
1 Radiation Oncology, Brigham and Womens Hospital and Dana-Farber Cancer Institute, Boston, MA; 2 Biostatistical Sciences and 4 Adult Oncology, Dana-Farber Cancer Institute, Boston, MA; 3 Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
Key words: chemotherapy, Hodgkins disease, radiation therapy, relapse, salvage therapy