J 2011

Eight Cycles of Escalated-Dose BEACOPP Compared With Four Cycles of Escalated-Dose BEACOPP Followed by Four Cycles of Baseline-Dose BEACOPP With or Without Radiotherapy in Patients With Advanced-Stage Hodgkin’s

BORCHMANN, Peter, Heinz HAVERKAMP, Volker DIEHL, Thomas CERNY, Jana MARKOVA et. al.

Basic information

Original name

Eight Cycles of Escalated-Dose BEACOPP Compared With Four Cycles of Escalated-Dose BEACOPP Followed by Four Cycles of Baseline-Dose BEACOPP With or Without Radiotherapy in Patients With Advanced-Stage Hodgkin’s

Authors

BORCHMANN, Peter (276 Germany, guarantor), Heinz HAVERKAMP (276 Germany), Volker DIEHL (276 Germany), Thomas CERNY (756 Switzerland), Jana MARKOVA (203 Czech Republic), Anthony HO (276 Germany), Hans Theodor EICH (276 Germany), Hans Konrad MULLER-HERMELINK (276 Germany), Lothar KANZ (203 Czech Republic), Richard GREIL (40 Austria), Andreas RANK (276 Germany), Ursula PAULUS (276 Germany), Lenka ŠMARDOVÁ (203 Czech Republic, belonging to the institution), Christoph HUBER (276 Germany), Bernd DORKEN (276 Germany), Christoph NERL (276 Germany), Stephan KRAUSE (276 Germany), Rolf-Peter MUELER (276 Germany), Michael FUCHS (276 Germany) and Andreas ENGERT (276 Germany)

Edition

Journal of Clinical Oncology, Alexandria, American Society of Clinical Oncology, 2011, 0732-183X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 18.372

RIV identification code

RIV/00216224:14110/11:00054478

Organization unit

Faculty of Medicine

DOI

UT WoS

000296797500012

Keywords in English

STUDY-GROUP GHSG; POSITRON-EMISSION-TOMOGRAPHY; ELDERLY-PATIENTS; MOPP/ABV HYBRID; INTERGROUP TRIAL; PROGNOSTIC SCORE; CLINICAL-TRIALS; COPP-ABVD; DISEASE; CHEMOTHERAPY

Tags

International impact
Změněno: 20/4/2012 12:09, Mgr. Michal Petr

Abstract

V originále

PURPOSE: Eight cycles of BEACOPP(escalated) (escalated dose of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) followed by radiotherapy (RT) to initial bulk or residual tumor mass is the German Hodgkin Study Group standard of care for advanced-stage Hodgkin's lymphoma (HL). However, treatment-related toxicity is a concern, and the role of RT in this setting is unclear. The HD12 study thus aimed to reduce toxicity while maintaining efficacy. PATIENTS AND METHODS: In this prospectively randomized multicenter trial, eight cycles of BEACOPP(escalated) was compared with four cycles of BEACOPP(escalated) followed by four cycles of the baseline dose of BEACOPP (BEACOPP(baseline); 4 + 4), and RT with no RT in the case of initial bulk or residual disease. The study was designed to exclude a difference in 5-year freedom from treatment failure (FFTF) rate of 6%. RESULTS: Between January 1999 and January 2003, 1,670 patients age 16 to 65 years were enrolled onto the HD12 study. At 5 years, FFTF was 86.4% in the BEACOPP(escalated) arm and 84.8% in the 4 + 4 arm (difference, -1.6%; 95% CI, -5.2% to 1.9%), and overall survival was 92% versus 90.3% (difference, -1.7%; 95% CI, -4.6% to 1.1%). Deaths related to acute toxicity of chemotherapy were observed in 2.9% of patients (BEACOPP(escalated), n = 19; 4 + 4, n = 27). FFTF was inferior without RT (90.4% v 87%; difference, -3.4%; 95% CI, -6.6% to -0.1%), particularly in patients who had residual disease after chemotherapy (difference, -5.8%; 95% CI, -10.7% to -1.0%), but not in patients with bulk in complete response after chemotherapy (difference, -1.1%; 95% CI, -6.2% to 4%). CONCLUSION: The reduction of BEACOPP to the 4 + 4 regimen did not substantially reduce severe toxicity but might decrease efficacy. Our results do not support the omission of consolidation RT for patients with residual disease. Alternative strategies for improving the risk-to-benefit ratio for patients with advanced HL are needed.