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, Anthony HO, Hans Theodor EICH, Hans Konrad MULLER-HERMELINK, Lothar KANZ, Richard GREIL, Andreas RANK, Ursula PAULUS, Lenka ŠMARDOVÁ, Christoph HUBER, Bernd DORKEN, Christoph NERL, Stephan KRAUSE, Rolf-Peter MUELER, Michael FUCHS a Andreas ENGERT. 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. Journal of Clinical Oncology. Alexandria: American Society of Clinical Oncology, 2011, roč. 29, č. 32, s. 4234-4242. ISSN 0732-183X. Dostupné z: https://dx.doi.org/10.1200/JCO.2010.33.9549.

Základní údaje

• Originální název: 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
• Autoři: BORCHMANN, Peter (276 Německo, garant), Heinz HAVERKAMP (276 Německo), Volker DIEHL (276 Německo), Thomas CERNY (756 Švýcarsko), Jana MARKOVA (203 Česká republika), Anthony HO (276 Německo), Hans Theodor EICH (276 Německo), Hans Konrad MULLER-HERMELINK (276 Německo), Lothar KANZ (203 Česká republika), Richard GREIL (40 Rakousko), Andreas RANK (276 Německo), Ursula PAULUS (276 Německo), Lenka ŠMARDOVÁ (203 Česká republika, domácí), Christoph HUBER (276 Německo), Bernd DORKEN (276 Německo), Christoph NERL (276 Německo), Stephan KRAUSE (276 Německo), Rolf-Peter MUELER (276 Německo), Michael FUCHS (276 Německo) a Andreas ENGERT (276 Německo).
• Vydání: Journal of Clinical Oncology, Alexandria, American Society of Clinical Oncology, 2011, 0732-183X.

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Článek v odborném periodiku
• Obor: 30200 3.2 Clinical medicine
• Stát vydavatele: Spojené státy
• Utajení: není předmětem státního či obchodního tajemství
• Impakt faktor: Impact factor: 18.372
• Kód RIV: RIV/00216224:14110/11:00054478
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.1200/JCO.2010.33.9549
• UT WoS: 000296797500012
• Klíčová slova anglicky: STUDY-GROUP GHSG; POSITRON-EMISSION-TOMOGRAPHY; ELDERLY-PATIENTS; MOPP/ABV HYBRID; INTERGROUP TRIAL; PROGNOSTIC SCORE; CLINICAL-TRIALS; COPP-ABVD; DISEASE; CHEMOTHERAPY
• Příznaky: Mezinárodní význam

Anotace

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.