© 2005 European Society for Medical Oncology
Original article |
A prospectively randomized trial carried out by the German Hodgkin Study Group (GHSG) for elderly patients with advanced Hodgkin's disease comparing BEACOPP baseline and COPP-ABVD (study HD9elderly)
1 Department of Internal Medicine I, University Hospital of Cologne, Cologne and the German Hodgkin Lymphoma Study Group; 2 Department of Pathology, University Hospital of Würzburg, Würzburg; 3 Department of Radiation Oncology, Ludwig Maximilian Universität München, Munich; 4 III. Medical Clinic, Klinikum Mannheim, Mannheim; 5 Department of Hematology, Klinikum Neukölln, Berlin; 6 Medical Clinic I, University Clinic Carl Gustav Carus, Dresden; 7 Department of Oncology, Hospital Harlaching, Munich; 8 Department of Radiation Oncology, University Hospital of Cologne, Cologne; 9 Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
* Correspondence to: Professor A. Engert, Department of Internal Medicine I, University Hospital of Cologne, Kerpener Str. 62, 50924 Cologne, Germany. Tel: +49-221-478-5933; Fax: +49-221-478-3778; Email: a.engert{at}uni-koeln.de
In contrast to younger patients, the prognosis of elderly patients with advanced Hodgkin's disease (HD) has not improved substantially over the last 20 years. We thus carried out a prospectively randomized study (HD9elderly) to compare the BEACOPP regimen in this setting against standard COPP-ABVD. Between February 1993 and 1998, 75 patients aged 66–75 years with newly diagnosed HD in advanced stages were recruited into the HD9 trial as a separate stratum (HD9elderly). Patients were assigned to eight alternating cycles of COPP and ABVD or eight cycles of BEACOPP in baseline doses. Radiotherapy was given to initial bulky or residual disease. In total, 68 of 75 registered patients were assessable: 26 were treated with COPP-ABVD and 42 with BEACOPP baseline. There were no significant differences between COPP-ABVD and BEACOPP in terms of complete remission (76%), overall survival (50%) and freedom from treatment failure (FFTF) (46%) at 5 years. At a median follow-up of 80 months, a total of 37 patients died: 14/26 patients (54%) treated with COPP-ABVD and 23/42 patients (55%) with BEACOPP. Two patients (8%) treated with COPP-ABVD and nine patients (21%) treated with BEACOPP died of acute toxicity. Hodgkin-specific FFTF at 5 years was 55% after COPP-ABVD and 74% after BEACOPP (P=0.13). Thus, there are no differences in survival between these regimens in elderly patients.
Key words: BEACOPP, chemotherapy, elderly patients, Hodgkin's lymphoma
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