2012
Dose-Intensification in Early Unfavorable Hodgkin's Lymphoma: Final Analysis of the German Hodgkin Study Group HD14 Trial
VON TRESCKOW, Bastian, Annette PLUETSCHOW, Michael FUCHS, Beate KLIMM, Jana MARKOVA et. al.Základní údaje
Originální název
Dose-Intensification in Early Unfavorable Hodgkin's Lymphoma: Final Analysis of the German Hodgkin Study Group HD14 Trial
Autoři
VON TRESCKOW, Bastian (276 Německo, garant), Annette PLUETSCHOW (276 Německo), Michael FUCHS (276 Německo), Beate KLIMM (276 Německo), Jana MARKOVA (203 Česká republika), Andreas LOHRI (756 Švýcarsko), Zdeněk KRÁL (203 Česká republika, domácí), Richard GREIL (40 Rakousko), Max S. TOPP (276 Německo), Julia MEISSNER (276 Německo), Josee M. ZIJLSTRA (528 Nizozemské království), Martin SOEKLER (276 Německo), Harald STEIN (276 Německo), Hans T. EICH (276 Německo), Rolf P. MUELLER (276 Německo), Volker DIEHL (276 Německo), Peter BORCHMANN (276 Německo) a Andreas ENGERT (276 Německo)
Vydání
Journal of Clinical Oncology, United States, American Society of Clinical Oncology, 2012, 0732-183X
Další údaje
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: 18.038
Kód RIV
RIV/00216224:14110/12:00060735
Organizační jednotka
Lékařská fakulta
UT WoS
000302628400008
Klíčová slova anglicky
INVOLVED-FIELD RADIOTHERAPY; NODE RADIOTHERAPY; CHEMOTHERAPY; DISEASE; PROGRESSION; INTENSITY; RADIATION; SURVIVAL; CYCLES
Příznaky
Mezinárodní význam
Změněno: 4. 9. 2012 13:15, Mgr. Michal Petr
Anotace
V originále
Purpose In patients with early unfavorable Hodgkin's lymphoma (HL), combined modality treatment with four cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) and 30 Gy involved-field radiotherapy (IFRT) results in long-term tumor control of approximately 80%. We aimed to improve these results using more intensive chemotherapy. Patients and Methods Patients with newly diagnosed early unfavorable HL were randomly assigned to either four cycles of ABVD or an intensified treatment consisting of two cycles of escalated BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone) followed by two cycles of ABVD (2 + 2). Chemotherapy was followed by 30 Gy IFRT in both arms. The primary end point was freedom from treatment failure (FFTF); secondary end points included progression-free survival (PFS) and treatment-related toxicity. Results With a total of 1,528 qualified patients included, the 2 + 2 regimen demonstrated superior FFTF compared with four cycles of ABVD (P < .001; hazard ratio, 0.44; 95% CI, 0.30 to 0.66), with a difference of 7.2% at 5 years (95% CI, 3.8 to 10.5). The difference in 5-year PFS was 6.2% (95% CI, 3.0% to 9.5%). There was more acute toxicity associated with 2 + 2 than with ABVD, but there were no overall differences in treatment-related mortality or secondary malignancies. Conclusion Intensified chemotherapy with two cycles of BEACOPP escalated followed by two cycles of ABVD followed by IFRT significantly improves tumor control in patients with early unfavorable HL.