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Annals of Oncology 8:S111-S114, 1997
© 1997 European Society for Medical Oncology

Patients with stage III/IV Hodgkin's disease in partial remission after MOPP/ABV chemotherapy have excellent prognosis after additional involved-field radiotherapy: Interim results from the ongoing EORTC-LCG and GPMC phase III trial

J. Raemaekers1, M. Burgers2, M. Henry-Amar3, A. Pinna3, A. Mandard3, S. Monfardini4, A. Hagenbeek5, W. Breed6, P. Carde7, M. Vovk8, A. van Hoof9, J. Thomas10 for the EORTC Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie, E. Noordijk11 for the EORTC Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie

1 University Hospital Nijimegen Nijimegen, the Netherlands
2 Netherlands Cancer Institute Amsterdam, the Netherlands
3 Centre François Baclesse Caen France
4 Centro di Riferimento Oncologico Aviano, Italy
5 Dr Daniel den Hoed Kliniek Rotterdam, the Netherlands
6 Comprehensive Cancer Center South-Netherlands Endhoven, the Netherlands
7 Institut Gustave Roussv Villejuif France
8 Institute of Oncology Ljubljana, Slovenia
9 St. Jan Hospital Bruges, Belgium
10 University Hospital Leuven Leuven, Belgium
11 University Hospital Leiden Leiden, the Netherlands

1Correspondence to: J. M. M. Raemaekers, MD, PhD Department of Hematology University Hospital Nijmegen P.O. Box 9101 6500 HB Nijmegen The Netherlands

Background Failure to reach complete remission (CR) with chemotherapy in advanced stages of Hodgkin's disease is considered a poor prognostic factor for progression-free and overall survival. The role of radiotherapy after chemotherapy-induced remission is controversial.

Patients and methods In 1989, the EORTC/GPMC started a randomized phase III trial on involved-field RT (IF-RT) after MOPP/ABV hybrid-induced remission in patients with stage III/IV Hodgkin's disease. In this ongoing trial, patients in CR after chemotherapy are randomized between IF-RT and no further treatment. Patients in partial remission (PR) all receive IF-RT. Patients, age 15–70 years, with previously untreated stage III/IV Hodgkin's disease are eligible. The randomized treatment arms are still blinded. The interim analysis of May 1996 focuses on the outcome of patients in chemotherapy-induced PR.

Results A total of 405 of 493 registered patients were evaluable for response to chemotherapy. Fifty-nine percent of patients attained a CR, 37% a PR, and only 4% failed to respond. The IF-RT was actually given to 90% of the PR patients. After a median follow-up of 43 months, the five year progression-free and overall survival for patients in PR was 75% and 87%, respectively.

Conclusions IF-RT after MOPP/ABV-induced partial remission in stage III/IV Hodgkin's disease produces excellent failure-free and overall survival. Early intensification of treatment of this group of patients is not indicated.

chemotherapy, Hodgkin's disease (advanced), radiotherapy


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