MOPP chemotherapy plus irradiation for Hodgkin's disease, stages IA TO IIIB. Long-term results of the prospective trial H72 (1972–1976, 334 patients)

✍ Scribed by Professeur Jean-Marie Andrieu; Max Dana; Jean-Pierre Desprez-Curely; Claude Jacquillat; Maryse Weil

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 837 KB
• Volume: 3
• Category: Article
• ISSN: 0278-0232
• DOI: 10.1002/hon.2900030402

✦ Synopsis

334 patients with Hodgkin's disease, CS IA-IIIB, were prospectively treated with combined chemotherapy and radiation. The 166 stages IA and II,A were clinically staged only; the 168 other patients were randomized to clinical or pathological staging. All patients received 3 or 6 cycles of MOPP followed by Mantle field with or without mediastinal irradiation and/or inverted Y or lumboaortic field according to initial stage, presentation and protocol. At completion of therapy, 317 patients were in complete remission. Twenty-six patients relapsed and 43 died including 5 with leukemia and 6 with infection. Overall 12-year survival and relapse-free rates are 86.6 f 3.08 per cent and 91.5 f 3.2 per cent respectively (IA: 95.3 and 95.3 per cent; IIA: 87.8 and 92.1 per cent; IIIA: 83.3 and 100 per cent; IB, IIB: 81.7 and 89.2 per cent; IIIB: 67.8 and 73.7 per cent). The randomized comparison between clinical staging plus 6 cycles of MOPP and laparotomy staging plus 3 cycles of MOPP in final stage I13+A, IB, IIB patients showed no significant 12-year survival differences (90.8 versus 85.6 per cent). With this combined modality treatment policy, high survival rates are obtained using only 3 cycles of MOPP and radiotherapy in CS IA, II,A and in PS II,,, IB, IIB. Laparotomy staging may be unnecessary if 6 cycles of MOPP are employed before irradiation in CS IIA, IB, IIB disease and if 3 cycles of MOPP are followed by irradiation in CSIA and II,A disease. Mediastinal irradiation can be avoided in patients with supradiaphragmatic disease without mediastinal involvement.