3 CYCLES OF ABDV PLUS EXTENDED FIELD RADIOTHERAPY IN PATIENTS WITH POOR-PROGNOSIS EARLY-INTERMEDIATE STAGE HODGKINS-DISEASE

The aim of the study was to verify the possibility of treating patient s with poor prognosis early-intermediate Hodgkin's disease with a comb ined modality therapy consisting of three cycles of ABVD followed by e xtended field irradiation (EFRT). No patient had bulky mediastinum or had previously been administered chemo- or radiotherapy. At pathologic al restaging, 40/44 (91%) evaluable patients achieved complete respons es (CR). After a ten-year followup, freedom from progression (FFP), re lapse-free survival (RFS) and overall survival (OS) were 80%, 83% and 81%, respectively. Of the prognostic factors, univariate analysis show ed that only stage III negatively influenced RFS, but not OS. Toxicity was mild except for subclinical mediastinal fibrosis in 32.5% of CR p atients. No patient reported reduced fertility. Two cases of second ne oplasms were recorded: one ameboid glioma and one thymoma, both occurr ing within five years after discontinuing chemo-radiotherapy. Our data suggest that three cycles of ABVD preceeding EFRT is an effective tre atment for poor prognosis early-intermediate stage Hodgkin's disease; nevertheless, stage III patients and some stage II patients with unfav orable prognostic factors should be treated with a more aggressive app roach.