ISSN:
1569-8041
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Purpose: At present, treatment results for patients withadvanced-stage Hodgkin's disease remain unsatisfactory. Standard chemotherapyM(C)OPP (nitrogen mustard (cyclophosphamide), vincristine, procabazine, andprednisone), ABVD (adriamycine, bleomycine, vinblastine, and dacarbacine) orM(C)OPP/ABVD +/− radiotherapy fail to achieve long-term completeremission in 35% to 50% of these patients. The BEACOPP(bleomycin, etoposide, adriamycine, cyclophosphamide, vincristine,procarbazine, and prednisone) regimen was developed to improve treatmentresults by dose intensification achieved by reduced duration of treatment(time intensification) and addition of etoposide. Patients and methods: Thirty untreated patients with advancedHodgkin's disease stage IIB–IV according to the Ann Arbor classificationwere treated with the time intensified BEACOPP regimen. Each patient wasscheduled to receive eight cycles of chemotherapy with consolidatingradiotherapy to sites of initial bulk disease and to residual tumor remainingafter chemotherapy. Results: All patients were evaluable for assessment of toxicity,treatment response, freedom from treatment failure (FFTF) and survival (SV).Of 30 treated patients, 29 patients received the intended eight cycles ofBEACOPP. One patient, in clinical CR, terminated the chemotherapy at his ownrequest after six cycles and is at this time, 48 months after the end oftreatment, in complete remission. Toxicity was tolerable with WHO grade 3/4leucopenia in 28% of chemotherapy cycles and one severe (WHO grade 3)infection. No treatment-related death occurred. Cycles could generally begiven on schedule. Complete remission (CR) was achieved in all but twopatients (93%). At present, only one patient has relapsed. At a medianfollow-up of 40 months, FFTF-rate is 89% (lower confidence limit:80%). One patient died due to progressive disease. Conclusion: The BEACOPP regimen is feasible at moderate hematopoeitictoxicity. With a FFTF-rate of 89% at a median follow-up of 40 months,the treatment results are very encouraging. A prospective randomised trial hasbeen initiated to compare the BEACOPP regimen with the standard COPP/ABVDregimen in advanced-stage Hodgkin's disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008294312741
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