RESULTS OF A RANDOMIZED TRIAL COMPARING MVPP CHEMOTHERAPY WITH A HYBRID REGIMEN, CHLVPP EVA, IN THE INITIAL TREATMENT OF HODGKINS-DISEASE/

Purpose and Methods: Between December 1984 and August 1992, 423 patien ts with newly diagnosed Hodgkin's disease (HD) were entered onto a ran domized clinical trial that compared the regimen of mechlorethamine, v inblastine, procarbazine, and prednisone (MVPP) with a doxorubicin-con taining hybrid regimen (chlorambucil, vinblastine, procarbazine, and p rednisone/etoposide, vincristine, and doxorubicin [ChlVPP/EVA]). Media n age for the group was 29.5 years (range, 15.2 to 68.8), and 52% had bulk disease. Results: After chemotherapy, patients in the hybrid arm of the trial had a higher complete remission (CR) rate (68.1% v 55.3%) and a lower failure rate (2.4% v 12.5%) than those in the MVPP arm, T here were also fewer deaths during treatment in the hybrid arm of the trial (five v 13). With a median follow-up period for survivors of 4.5 years (range, 0 to 9), actuarial 5-year progression-free survival (PF S) for all cases is 80% in the hybrid arm and 66% in the MVPP arm (P = .005). A nonsignificant trend toward a better overall survival in the hybrid arm of the trial has also been identified. Conclusion: These r esults suggest that ChlVPP/EVA hybrid is superior to MVPP in the treat ment of HD. it has therefore been adopted as standard first-line thera py at the two centers. (C) 1995 by American Society of Clinical Oncolo gy.