Hodgkin's disease in adults in Saudi Arabia. Clinical features, prognostic factors and an analysis of therapy. Outcome of combination chemotherapy only, for both localized and advanced disease
✍ Scribed by Hassan Y. Al-Idrissi; Ezzeldin M. Ibrahim
- Publisher
- John Wiley and Sons
- Year
- 1991
- Tongue
- French
- Weight
- 509 KB
- Volume
- 47
- Category
- Article
- ISSN
- 0020-7136
No coin nor oath required. For personal study only.
✦ Synopsis
Fifty evaluable, previously untreated, adult patients with clinically staged (CS) early and advanced Hodgkin's disease were treated with chemotherapy alone, using various re ihad CS I or II and 35 (70%) had CS 111 or IV. Eighty-eight per cent of patients had one or more of the B symptoms and 64% had an unfavorable histology. Complete remission (CR) was achieved in 43 out of 50 patients (86% with 95% confidence interval of 76% to 96%). partial remission in 3 (6%) and treatment failure in 4. Adjusted analysis, using all possible subset regression, showed that unfavorable histology, bulky disease and receiving a total dose-intensity (TDI) C 0.80 were negatively associated with the likelihood of achieving CR. At a median follow-up of 36 months (range, 6-90), 84% of patients were alive and 82% were disease-free. The overall median survival has not been reached, but the projected 5-year survival probability was 79%. Time-to-relapse was also estimated for those who achieved initial CR. The estimated 5year relapse-free survival was 87%. The Cox proportional hazards model predicted that unfavorable histology, bulky disease and TDI S 0.80 had an independent, adverse influence on survival. We conclude that the results of chemotherapy alone are encouraging and the rationale is practical and acceptable in those countries where the availability of radiotherapy units is limited. mens. Their mean age was 3 I .9 years. Fifteen patients ( 3 0 X ) t Hospital-based statistics from a single institution have shown that Hodgkin's disease in Saudi Arabia ranked loth, with a crude relative frequency of 3.6%, in a total of 7,251 cancer patients (El-Akkad et al., 1986). This high incidence of Hodgkin's disease in Saudi Arabia, together with the limited availability of radiotherapeutic facilities, has required the use of systemic combination chemotherapy alone for the management of both localized and advanced disease.
In this report we present data on the pattern of Hodgkin's disease in Saudi Arabia. We also analyze the outcome of treating early and advanced clinically staged patients using combination chemotherapy alone.