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Early response to chemotherapy as a prognostic factor in Hodgkin's disease
Author(s) -
Kuentz M.,
Reyes F.,
Brun B.,
Lebourgeois J. P.,
Bierling P.,
Farcet J. P.,
Vernant J. P.,
Imbert M.,
Bezu M. Le,
Rochant H.,
Dreyfus B.
Publication year - 1983
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19830901)52:5<780::aid-cncr2820520504>3.0.co;2-1
Subject(s) - medicine , chemotherapy , stage (stratigraphy) , regimen , disease , radiation therapy , gastroenterology , surgery , oncology , paleontology , biology
In 164 patients with Hodgkin's disease staged between 1973 and 1979 the response to the 3 initial cycles of multiagent chemotherapy was evaluated as a prognosticator of survival. Treatment of localized disease (Stages I, II, III1) consisted of 3 cycles of chemotherapy followed by subtotal nodal irradiation, including the splenic area in non splenectomized patients. Treatment of extended disease (Stage III2 and IV) consisted of 6 cycles followed by low‐dosage radiotherapy of initial bulky disease. Five‐year actuarial survival was 88% in Stage I, 80% in II, 100% in III1, 45% in III2 and IV. Chemotherapy‐induced complete remission after 3 cycles (CH → CR) was associated with a favorable prognosis. Five‐year survival of Stage III2 and IV patients was better in those who reached CH → CR than in those who did not (75% versus 25%; P < 0.01). This relationship between CH → CR and five‐year survival was confirmed in patients with localized disease, as shown in Stage II patients (respectively 97% versus 63%; P < 0.05). Therefore the response to initial chemotherapy provides a new prognostic factor that may serve to delineate a “high‐risk” group of patients. The latter deserve aggressive therapy while those in the favorable group would benefit from a less aggressive combined regimen that would minimize long‐term complications.