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Annals of Oncology Advance Access published online on September 16, 2009
Annals of Oncology, doi:10.1093/annonc/mdp337
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Stanford V program for locally extensive and advanced Hodgkin lymphoma: the Memorial Sloan-Kettering Cancer Center experience

S. M. Edwards-Bennett1, L. M. Jacks2, C. H. Moskowitz3, E. J. Wu1, Z. Zhang2, A. Noy3, C. S. Portlock3, D. J. Straus3, A. D. Zelenetz3 and J. Yahalom1,*

From the Lymphoma Disease Management Team
1 Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
2 Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
3 Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

* Correspondence to: Dr J. Yahalom, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Tel: +212-639-5999; Fax: +1-212- 639-8876; E-mail: yahalomj{at}mskcc.org

Background: The Stanford group has reported excellent results with the Stanford V regimen for patients with bulky and/or advanced Hodgkin lymphoma (HL). However, Gobbi reported markedly inferior failure-free survival (FFS) comparing Stanford V to other regimens but included major deviations from the original program. We retrospectively examined whether treatment at our institution carefully following Stanford V guidelines would confirm the original Stanford outcome data.

Patients and methods: From June 1995 to May 2002, 126 patients with either locally extensive or advanced HL were treated with the 12-week Stanford V chemotherapy program followed by 36-Gy involved-field radiotherapy to sites initially ≥5 cm and/or to macroscopic splenic disease. Overall, 26% had stage IV disease and 20% had international prognostic score (IPS) ≥4. Overall survival (OS), disease-specific survival, progression-free survival (PFS), FFS, and freedom from second relapse (FF2R) were determined.

Results: The 5- and 7-year OS were 90% and 88%, respectively. The 5-year FFS was 78%. IPS ≥4 was a significant independent predictor of worse OS and PFS. The FF2R was 64% at 3 years.

Conclusion: Stanford V with appropriate radiotherapy is a highly effective regimen for locally extensive and advanced HL.

combined modality, Hodgkin lymphoma, involved-field radiotherapy, Stanford V

Received for publication February 26, 2009. Revision received May 18, 2009. Accepted for publication May 20, 2009.


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