AUGMENTED THERAPY OF EXTENSIVE HODGKINS-DISEASE - RADIATION TO KNOWN DISEASE OR PROLONGATION OF INDUCTION CHEMOTHERAPY DID NOT IMPROVE SURVIVAL - RESULTS OF A CANCER AND LEUKEMIA GROUP-B STUDY

Purpose: This prospective randomized trial in extensive untreated Hodg kin's disease was undertaken to assess the potential benefit of augmen ted therapy (12 months chemotherapy or radiation to known disease) com pared to standard 6 months chemotherapy. Patient and Methods: A total of 258 patients, mostly Stage IV, were randomized to four treatment re gimens consisting of six cycles of CCNU, vinblastine, procarbazine, an d prednisone (CVPP); 12 cycles of CVPP; six cycles of CVPP followed by 25 Gy radiotherapy; or three cycles CVPP, 25 Gy radiotherapy, and thr ee cycles CVPP. Results: Complete remissions were achieved in 65% of a ll patients. A 58% overall 5-year survival rate was obtained. Relapses in irradiated areas of known disease occurred in only 6% of respondin g patients. There was, however, no statistical difference in response frequency, disease-free survival, or overall survival among the four r egimens. Elderly patients responded less frequently. Conclusion: While radiotherapy provided control of local (known) disease, no impact on overall survival was apparent. Likewise, doubling the duration of chem otherapy did not improve response or survival. Augmentation of therapy with either radiotherapy or more chemotherapy in this study was of no benefit compared to the standard 6 months of treatment. (C) 1998 Else vier Science Inc.