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Annals of Oncology 7:S109-S113, 1996
© 1996 European Society for Medical Oncology

Reviews

Current clinical trials in Hodgkin's disease

K. Reuß, A. Engert, H. Tesch and V. Diehi

Medizinische Universitätsklinik I Köln, Germany

Correspondence to: Prof.Dr. V. Diehl Medizinische Universitätsklinik I Josef-Stelzmann-Str.9 D 50924 Köln Germany

With the advent of modern polychemotherapy and radiation techniques, cure rates in Hodgkin's disease (HD) have improved substantially. This article summarises current concepts of treatment for early, intermediate and advanced stage HD. Current strategies focus on the balance between cure rate and toxicity. In early stages, cure rates approach 90% and new strategies mainly try to avoid toxicities. Possible approaches comprise the use of less CT or RT or leaving laparotomy. In advanced stages, polychemotherapy with 8 courses of either M(C)OPP or ABVD or M(C)OPP/ABVD is considered to be the treatment of choice, but unsatisfactory low complete remission rates, progression-free survival or freedom from treatment failure rates have to be improved. The role of additional radiotherapy after extensive chemotherapy in the treatment of advanced stages is uncertain. To achieve a better tumour control, new regimens have been The Stanford group initiated the 12-week intensified hybrid protocol Stanford V. The German Hodgkin's Lymphoma Study Group (GHSG) introduced the BEACOPP protocol with time intensification and dose escalation of cyclophosphamide and etoposide. The Milan Cancer Institute tries to improve treatment outcome using high doses of single agents. One problem to be addressed in ongoing and future trials is the identification of high-risk groups allowing an early stratification of patients into more agressive but effective regimens. Risk-adapted therapy might allow further reduction of doses in patients with early-stage Hodgkin's disease.

chemotherapy, clinical trials, current strategies, dose escalation, high-dose single agent chemotherapy, Hodgkin's disease, radiotherapy, time intensification, treatment


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